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Influence of C-reactive Protein on Thrombin Generation Assay

1University of Namur, Faculty of Medicine, Department of Pharmacy, Namur, Belgium, 2Qualiblood sa, Namur, Belgium, 3Université Catholique de Louvain, CHU UCL Namur, Laboratory Hematology, Yvoir, Belgium, 4Université Catholique de Louvain, CHU UCL Namur, Department of Anesthesiology, Yvoir, Belgium, 5Clinique Saint-Luc Bouge A.S.B.L 'Santé et Prévoyance', Bouge, Belgium

Abstract Number: PB0243

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: C-reactive protein (CRP) is an acute phase reactant plasma protein considered as biomarker representative of the burden of inflammation also linked to the development of prothrombotic states. In moderate to severe COVID-19 patients, persistent elevated levels of CRP were observed contributing to the risk of venous thromboembolic events. CRP is known to artefactually interfere with certain coagulation assays. As the use of global coagulation test like thrombin generation assay (TGA) may be relevant to characterize the evolution of the disease or identify its severity, it is interesting to investigate the impact of CRP on TGA.

Aims: This study aimed to assess how CRP impacts TGA on the automated ST Genesia system, using the STG-ThromboScreen- TM as triggering reagent. A comparison with the Calibrated Automated Thrombogram (CAT) system was performed.

Methods: Normal pooled plasma (NPP) constituted of 50 healthy individuals was used as the matrix. Human CRP (Merk, Germany) was spiked in NPP at five relevant plasma concentrations (0 [=Phosphate buffer saline], 50, 100, 200 and 350 mg/L). Both TGA methods were performed in duplicate and assessed by 3 independent runs.

Results: Based on mean values, no statistically significant difference was observed between the five tested concentrations (p-value >0.05), regardless of the platform used. On the other hand, the comparison between both analyzers showed significant differences for lag-time and time-to-peak, which were significantly higher when TGA was performed on the CAT system. These differences are possibly associated with the specific algorithm of each platform.

Conclusions: This study demonstrated that CRP levels up to 350mg/L did not impact significantly thrombin generation performed either on CAT or on ST Genesia system. Therefore, TGA could be an efficient test to assess the hemostatic function of patients with elevated CRP, like those in sepsis and suffering from chronic or acute inflammatory conditions, such as COVID-19.

To cite this abstract in AMA style:

Didembourg M, Douxfils J, Mullier F, Hardy M, Favresse J, Morimont L. Influence of C-reactive Protein on Thrombin Generation Assay [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/influence-of-c-reactive-protein-on-thrombin-generation-assay/. Accessed September 16, 2021.

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