ISTH Congress Abstracts

Official abstracts site for the ISTH Congress

MENU 

Overall Haemostatic Potential (OHP) assay can risk stratify for venous thromboembolism recurrence in anticoagulated patients

1Northern Health, Melbourne, Victoria, Australia, 2Northern Pathology Victoria, Department of Haematology, Northern Health, Epping, VIC, Epping, Victoria, Australia, 3Alfred Health and the Australian Centre for Blood Diseases and Monash University, Melbourne, Victoria, Australia, 4Northern Health, Victoria, Australia, Epping, Victoria, Australia

Abstract Number: PB0142

Meeting: ISTH 2022 Congress

Theme: Diagnostics and OMICs » Biomarkers of Thrombosis and Hemostasis

Background: Assessing the risk of recurrent venous thromboembolic (VTE) events, particularly when patients remain on anticoagulation, remains a major challenge largely due to lack of biomarkers.

Aims: We aimed to investigate the use of the OHP assay in newly diagnosed patients following VTE and explore its role in the risk stratification of VTE recurrence, including in patients whilst receiving anticoagulation.

Methods: Adult patients following VTE were recruited between January 2018 and September 2020. Platelet-poor plasma was obtained whilst patients remained on therapeutic anticoagulation. Overall haemostatic potential (OHP) assay, which evaluates fibrin formation with and without tissue plasminogen activator (tPA), was performed on all plasma samples. Time-to-event analysis was performed with recurrent VTE or recurrent unprovoked VTE as endpoints.

Results: OHP assay results were obtained from 196 patients (52.6% male) with a mean age of 57.1 years. Compared to healthy subjects, VTE patients displayed significantly higher overall coagulation potential (without tPA) (39.6 v 34.5 units, p < 0.001) and OHP (with tPA) (9.3 v 6.4 units, p < 0.001) as well as lower overall fibrinolytic potential (OFP) (75.6 v 81.1%, p < 0.001). There were 16 VTE recurrences including 11 unprovoked, all of which occurred above an OCP cut-off of 40th percentile (recurrence rate 4.32 per 100 patient-years, 95% confidence interval (CI) 2.39-7.80, p=0.002). Of 97 patients who subsequently ceased anticoagulation, all unprovoked VTE recurrences (n=9) occurred above the 40th OCP percentile (recurrence rate 9.10 per 100 patient-years, 95% CI 4.74-17.49, p=0.005) and the 40th OHP percentile (recurrence rate 8.46 per 100 patient-years, 95% CI 4.40-16.25, p=0.009). OCP performed better than D-dimer at predicting unprovoked VTE recurrence (AUC 0.72 vs 0.43).

Conclusion(s): Our pilot study demonstrates that the OHP assay can detect a hypercoagulable and hypofibrinolytic state in anticoagulated VTE patients and may be able to risk stratify for VTE recurrence, allowing for more individualised targeting of long-term anticoagulation.

Table

Baseline characteristics and OHP results for healthy controls and VTE patients

Figure

Kaplan-Meier curves of unprovoked recurrent VTE -n=9- in patients without long-term anticoagulation prophylaxis -n=97-

To cite this abstract in AMA style:

Wang J, Lim H, Brook R, Nandurkar H, Ho P. Overall Haemostatic Potential (OHP) assay can risk stratify for venous thromboembolism recurrence in anticoagulated patients [abstract]. https://abstracts.isth.org/abstract/overall-haemostatic-potential-ohp-assay-can-risk-stratify-for-venous-thromboembolism-recurrence-in-anticoagulated-patients/. Accessed September 29, 2023.

« Back to ISTH 2022 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/overall-haemostatic-potential-ohp-assay-can-risk-stratify-for-venous-thromboembolism-recurrence-in-anticoagulated-patients/