Abstract Number: PB0756
Meeting: ISTH 2020 Congress
Background: Prothrombin complex concentrates (PCCs) are used in clinical practice to reverse major bleeding while on anticoagulant therapy and for the treatment and prophylaxis of inherited and acquired bleeding disorders. Thrombin generation essential for clot strength is enhanced when PCC is administered.
Aims: To assess clot stability in plasma spiked with PCC using clot lysis time assay.
Methods: The clot lysis time assay incorporating phospholipid 10µM, tissue factor 5pM, and calcium 17mM (final concentrations) was performed in a 96 well plate. Clot lysis was achieved with the addition of tissue plasminogen activator 50ng/mL (final). Normal pooled plasma (NPP) obtained from ten healthy volunteers was tested at baseline and after addition of three concentrations of PCC: 0.15 IU/mL, 0.3 IU/mL and 0.6 IU/mL. Clotting factors (Factor II, VII, IX, X and Fibrinogen) and anticoagulants (Protein S and Protein C) were measured in NPP pre and post PCC addition.
Changes in optical density (OD) as a result of clot formation and lysis were measured kinetically using a spectrophotometer (37oC, 405 nm). Clot lysis times (CLTs) were calculated using Excel.
Results: Addition of PCC to NPP resulted in a dose dependent increase in maximum OD when compared to NPP alone. Similarly, we observed a progressive prolongation of CLTs with corresponding increments in PCC concentration. PCC 0.15 IU/ml, 0.30 IU/ml and 0.60 IU/ml resulted in CLTs of 68.5 min, 69.5 min and 73.5min respectively. From the NPP CLT of 64.5 min to the highest PCC concentration there was an increase of 12.2%.
Conclusions: Increasing the concentration of pro-coagulant factors in plasma by adding PCC results in clots that are more resistant to fibrinolysis. Further research is needed to investigate CLT in parallel to thrombin generation to better understand the impact of PCC in correcting coagulopathies.
To cite this abstract in AMA style:Garcia CD, Chowdary P, Peralta MR, Hanif Z, Riddell A, Lawler P, Dailani L, Hamid C. The Influence of Prothrombin Complex Concentrates on Clot Stability [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-influence-of-prothrombin-complex-concentrates-on-clot-stability/. Accessed January 21, 2022.
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