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Measurement of β-antithrombin activity in healthy individuals and in patients with different types of antithrombin deficiency

É. Katona1, R. Gindele2, É. Molnár2, E. Uj2, Z. Bereczky3

1University of Debrecen, Faculty of Medicine, Debrecen, Hajdu-Bihar, Hungary, 2Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hajdu-Bihar, Hungary, 3Faculty of Medicine, University of Debrecen, Debrecen, Hajdu-Bihar, Hungary

Abstract Number: PB0546

Meeting: ISTH 2022 Congress

Theme: Coagulation and Natural Anticoagulants » Coagulation Factors and Inhibitors

Background: The β glycoform of antithrombin (AT) has higher heparin affinity than α-form and accounts for 5-10% of total AT in normal plasma. β-AT is thought to play a greater role in the prevention of thrombosis during vessel-wall injury. It may have an impact on the thrombotic risk in AT deficiency. Since measurement of this isoform is not performed routinely, the level of β-AT in these patients is unknown.

Aims: To determine the activity of total and β-AT in healthy controls and in AT deficient patients.

Methods: Anti-FXa chromogenic method in the presence of heparin and its modified version in the presence of high (1.1M) NaCl concentration were used in 50 controls and 79 patients.

Results: In the controls, the median (IQR) total AT activity was 105 (98-116)% and the β-AT activity was – as expected – 8.9 (8.2-9.2)%. The calculated β-AT percentage of total AT activity (β-AT%) was 8.3 (7.9-8.8)%. In type II heparin binding site (IIHBS) deficient AT Budapest 3 heterozygotes (n=50) the total AT activity, the β-AT activity and the β-AT% were 58 (54-61)%, 8.4 (8.2-8.9)% and 14.5 (13.9-15.6)%, respectively. These results were in concordance with those measured in AT type IIHBS Basel and Padua (n=2) patients. In AT Budapest 3 homozygotes (n=9) total AT activity, β-AT activity and β-AT% were 17 (15-26)%, 7.4 (6.8-10.2)% and 41.6 (38.6-48.0)%, respectively. On the contrary, in patients having type I AT defect – although total AT activity was comparable with type IIHBS heterozygotes, 52 (46-53)% – the β-AT activity was significantly lower, 6.8 (6.5-7.2)%.

Conclusion(s): Our results show that – while in type I quantitative AT deficiency the total and β-AT activity are proportionally decreased – the activity of β-AT is less affected by type IIHBS AT mutations. These results support the clinical observations of less severe thrombotic phenotype in type IIHBS deficiency.

To cite this abstract in AMA style:

Katona É, Gindele R, Molnár É, Uj E, Bereczky Z. Measurement of β-antithrombin activity in healthy individuals and in patients with different types of antithrombin deficiency [abstract]. https://abstracts.isth.org/abstract/measurement-of-%ce%b2-antithrombin-activity-in-healthy-individuals-and-in-patients-with-different-types-of-antithrombin-deficiency/. Accessed September 29, 2023.

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