Abstract Number: PB1286
Meeting: ISTH 2021 Congress
Background: The use of combined oral contraceptives has been associated with an increased risk of thromboembolic disease. Current in vitro tests are focusing on one or some sets of multiple factors but are not really pharmacodynamic tests. In this study we present thrombodynamics, which is an elegant in vitro analysis that resembles in vivo coagulation starting from a prothrombotic surface and gives insight in the spatial dynamics of the formation of a fibrin clot and thrombin generation.
Aims: Investigate the effect of 6 month treatment of three different types combined oral contraceptives belonging to either the 2nd generation or a 3rd generation COC (Ethinylestradiol 30 µg – Desogestrel 150 µg; or Ethinylestradiol 20 µg – Desogestrel 150 µg) in healthy woman on fibrin clot growth and thrombin generation.
Methods: The coagulation state of blood plasma samples was quantitatively evaluated using a Thrombodynamics Analyzer System T-2 (Hemacore). This system records the fibrin clot light scattering changes in a time-lapse video microscopy mode and records the fluorescence signal during cleavage of synthetic AMC-based substrate by thrombin. Next, numerical parameters are calculated describing the coagulation process.
Results: Data show that fibrin clot formation and thrombin generation are increased after 6 months treatment of combined oral contraceptives. Figure 1 shows the size of the clot before and after 6 month treatment; Figure 2 shows the individual changes in thrombin formation in the clot.
Conclusions: The use of three types of COC (30EELNG, 30EEDSG and 20EEDSG) is involved in the increased risk of thromboembolic disease. Both the fibrin clot size and thrombin generation increased after 6 months treatment of COC. The read outs are consequences of multiple factors unlike reductionistic approaches of other tests. Furthermore, with thrombodynamics the ‘high hemostatic responders’ can be identified who may have the highest risk to develop thrombogenic effects while using COCs.
To cite this abstract in AMA style:de Kruijf P, Naji S, Krijnen C, Jespersen J, Kluft C. A New Pharmacodynamic Test to Evaluate Effects of Oral Contraceptives on Coagulation [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/a-new-pharmacodynamic-test-to-evaluate-effects-of-oral-contraceptives-on-coagulation/. Accessed September 24, 2021.
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