Abstract Number: PB0370
Meeting: ISTH 2021 Congress
Background: The thrombin generation (TG) assay is a feasible but labor-intensive method for detecting global coagulation. It enables comprehensive assessment of anticoagulation, while drug-specific assays only assess exposure. Traditionally, the Calibrated Automated Thrombogram (CAT®) has been used, however the ST Genesia® (Diagnostica Stago) allows automated evaluation.
Aims: We aimed to observe coagulation using the ST Genesia® and compare the data with those of CAT® in anticoagulated patients.
Methods: Altogether, In total, 43 frozen-thawed samples were studied using DrugScreen® to assess direct oral anticoagulants (DOACs), warfarin, and low molecular-weight heparin. Twenty samples (nine rivaroxaban, five apixaban, three warfarin, and three heparin) were also compared using CAT® (5 pM tissue factor).
Results: TG reduction in DrugScreen® depended on the specific drug and modestly correlated with DOAC levels (lag time R2 = 0.36; peak R2 = 0.50, Figure). The best correlation was observed with Peak thrombin and rivaroxaban-specified anti-Xa activity (R2=0.60). When comparing ST Genesia® with CAT®, only the results for apixaban concorded (R2 = 0.97). Unlike CAT®, ST Genesia® yielded a normal endogenous thrombin potential (ETP) in 77% (24/31) FXa-inhibitor cases, and it failed to give readouts at INR ≥ 4.5 and at anti-Xa ≥ 1.0 IU/mL.
Conclusions: The ST Genesia® data did not correlate with CAT®, but it was independently associated with INR, anti-Xa, and DOAC concentrations. The Lag time and Peak responses were similar; the major differences were that ST Genesia® showed no ETP effect of DOACs, and failed to give readout at high INR or anti-Xa activity.
These data have been accepted for publication in Research and Practice in Thrombosis and Haemostasis 23.1.2021.
To cite this abstract in AMA style:Helin T, Lemponen M, Lassila R, Joutsi-Korhonen L. Anticoagulated Patients Exhibit Intact Endogenous Thrombin Potential Using ST Genesia Unlike the Calibrated Automated Thrombogram [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/anticoagulated-patients-exhibit-intact-endogenous-thrombin-potential-using-st-genesia-unlike-the-calibrated-automated-thrombogram/. Accessed September 24, 2023.
« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/anticoagulated-patients-exhibit-intact-endogenous-thrombin-potential-using-st-genesia-unlike-the-calibrated-automated-thrombogram/