Abstract Number: PB0710
Meeting: ISTH 2020 Congress
Background: Thrombin generation and other clotting assays suffer from a wide variation of pre-analytical variables. One of those pre-analytical variables is contact activation through blood withdrawal methods, different syringes, differences in blood coagulation tubes, blood transport and sample handling. It has been shown that the addition of contact activation inhibitors in low tissue factor activated thrombin generation leads to a correction of the, in these circumstances significant, increase in thrombin generation due to contact activation. We compare thermostable inhibitor of contact activation (TICA) to the currently used corn trypsin inhibitor (CTI).
Aims: To compare the effectiveness of novel contact activation inhibitor TICA to CTI in low tissue factor-induced thrombin generation and recalcification in sodium citrate anticoagulated platelet poor plasma (PPP) and platelet rich plasma (PRP).
Methods: We compared TICA, CTI and plasma without contact activation inhibitors in low tissue factor PPP thrombin generation and in PRP recalcification thrombin generation, the latter the most sensitive condition for contact activation. In addition, off-target effects were investigated using factor XII-deficient plasma. Thermostability – as a measure of shelf life – was measured and compared to CTI. Effectivity of contact activation inhibition before and after blood withdrawal was tested using thrombin generation.
Results: TICA is able to fully block contact activation in recalcified PRP and is comparable to CTI in doing so. TICA significantly lowers low tissue factor-induced thrombin generation by blocking contact activation. Pre-loading vacuum blood collection tubes with contact activation inhibitors is superior in inhibiting contact activation compared to addition of the inhibitor during the thrombin generation assay itself. TICA did not alter coagulation activity when added to FXIIa deficient plasma in thrombin generation. TICA, in contrast to CTI, is heat-stable improving processing and shelf life of pre-loaded blood drawing tubes.
Conclusions: TICA is able to fully block contact activation and has several advantages over CTI.
To cite this abstract in AMA style:van de Berg T, Suylen D, Thomassen S, van Oerle R, Spronk H, Apitz R, Hemker C, Hackeng T. Thermostable Inhibitor of Contact Activation (TICA) Fully Blocks Contact Activation when Added to Blood Withdrawal Tubes [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/thermostable-inhibitor-of-contact-activation-tica-fully-blocks-contact-activation-when-added-to-blood-withdrawal-tubes/. Accessed January 27, 2022.
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