Abstract Number: PB0308
Meeting: ISTH 2021 Congress
Theme: Diagnostics and OMICs » Biomarkers of Thrombosis and Hemostasis
Background: The Overall Haemostatic Potential assay (OHP) is a global coagulation assay that measures fibrin generation and fibrinolysis potential. The OHP has been poorly studied among patients with VTE.
Aims: To characterise fibrin generation and fibrinolysis in anticoagulated VTE patients using the OHP assay.
Methods: Adult patients were recruited following a confirmed diagnosis of DVT and/or PE, and blood sampled whilst receiving therapeutic anticoagulation. Platelet poor plasma (PPP) was analysed by the OHP assay in which fibrin generation and fibrinolysis is measured spectrophotometrically at 405nm. The overall coagulation potential (OCP) is the area under the time-curve of PPP activated by thrombin. The OHP is determined by the addition of tPA (350ng/mL) and thrombin to a parallel plasma sample. The overall fibrinolysis potential (OFP) is calculated by (OCP-OHP)/OCPx100%.
Results: From Jan 2018 to Jan 2021, 208 patients were recruited. Compared with normal control patients (previous data), study subjects displayed significantly higher OCP, OHP, and reduced OFP (Table 1). There were no significant differences between provoked/unprovoked or major/minor VTE. Patients with active malignancy, or subsequently diagnosed with malignancy showed higher OHP and reduced OFP compared to those without malignancy (Table 1). Patients with residual PEs had significantly higher OCP and OHP compared with those with none. No differences were found according to the presence of residual thrombus in those with DVT only. Patients receiving warfarin (Table 2) displayed significantly higher OCP and OHP compared to those treated with DOACs, which may be due to patient differences as displayed in Table 2.
| Normal control | All subjects | p | Malignancy | No malignancy | p | PE/DVT with no residual PE | PE/DVT with residual PE | p | |
| No. results | 143 | 208 | 17 | 189 | 74 | 13 | |||
| OCP | 35.7 | 41.54 | <0.0001 | 46.61 | 41.33 | 0.06 | 39.65 | 47.92 | 0.01 |
| OHP | 7.3 | 11.28 | <0.0001 | 15.41 | 10.95 | 0.002 | 10.43 | 14.92 | 0.02 |
| OFP% | 80.1 | 73.62 | <0.0001 | 68.53 | 74.19 | 0.01 | 74.32 | 71.48 | 0.28 |
OHP results of various sub-populations of VTE patients
| Warfarin N=37 |
DOACs N=155 |
p-value | |
| OCP, mean | 48.09 | 39.84 | <0.001 |
| OHP, mean | 13.08 | 10.49 | 0.006 |
| OFP, mean | 73.87 | 74.20 | 0.82 |
| Age | 55.90 | 56.00 | 0.96 |
| Weight | 113.27 | 89.18 | <0.001 |
| D-dimer | 0.44 | 0.56 | 0.68 |
| F8 | 196.06 | 146.97 | <0.001 |
| vWF Ag | 199.74 | 145.09 | <0.001 |
| Fibrinogen | 4.40 | 3.60 | <0.001 |
OHP results and patient characteristics of patients treated with warfarin vs DOACs
Conclusions: Hypercoagulability and hypofibrinolysis were detected by the OHP assay in patients receiving anticoagulation after acute VTE. Individuals with malignancy, with residual PE and anticoagulated with warfarin had significantly hypercoagulable and/or hypofibrinolytic results. Further study is required to confirm the effect of anticoagulation on OHP, and the utility of using OHP to prognosticate for VTE recurrence.
To cite this abstract in AMA style:
Wang J, Ho P. Overall Haemostatic Potential Assay Can Detect Hypercoagulability and Hypofibrinolysis in Anticoagulated Patients Following Venous Thromboembolism [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/overall-haemostatic-potential-assay-can-detect-hypercoagulability-and-hypofibrinolysis-in-anticoagulated-patients-following-venous-thromboembolism/. Accessed September 22, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/overall-haemostatic-potential-assay-can-detect-hypercoagulability-and-hypofibrinolysis-in-anticoagulated-patients-following-venous-thromboembolism/