Laurie Talon1, Thomas Sinegre1, Thomas Lecompte2, Bruno Pereira3, Sylvie Massoulié4, Armand Abergel4, Aurélien Lebreton1. 1. Service d'hématologie biologique, CHU Clermont-Ferrand, Clermont-Ferrand, France. 2. Hôpitaux Universitaires de Genève, Unité d'hémostase, Département de médecine, faculté de Médecine - GpG, Université de Genève, Geneva, Switzerland. 3. Unité de Biostatistiques (Direction de la recherche clinique et de l'innovation), CHU Clermont-Ferrand, Clermont-Ferrand, France. 4. Service d'Hépato-Gastro-Entérologie, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Abstract
BACKGROUND: Thrombin generation assays (TGAs) performed with calibrated automated thrombography (CAT) in the presence of thrombomodulin (TM) indicate plasma hypercoagulability in cirrhosis. OBJECTIVE: To evaluate, in the presence of TM, the new ST-Genesia automated device developed for improving TGA vs the previously used CAT method, with plasma samples of patients with cirrhosis. PATIENTS/ METHODS: Platelet-poor plasma samples were prepared from citrated blood samples of 52 healthy controls and 85 patients with cirrhosis (severity evaluated using the Child-Pugh score [CP]). TGAs were performed using CAT with PPP-Reagent and ST-Genesia with the STG-ThromboScreen reagent, in the presence of TM. Endogenous thrombin potential (ETP) was chosen as the main parameter. RESULTS: Whatever the method, ETP values were higher in patients than in healthy controls. All patients identified as hypercoagulable with ST-Genesia and STG-ThromboScreen were found hypercoagulable with CAT and PPP-Reagent. Conversely, eight and ten patients in the CP-A and CP-B classes respectively were identified as hypercoagulable only with CAT. The use of ST-Genesia with the STG-ThromboScreen reagent with TM led to a bias, with higher ETP values for healthy controls and lower for patients compared with CAT. Crossover analysis (CAT with the STG-ThromboScreen reagent) evidenced a substantial effect of the STG-ThromboScreen reagent; the analyzer (including calibration and data analysis) plays a lesser role. CONCLUSION: ST-Genesia evidences hypercoagulability in patients with cirrhosis when TG is studied in the presence of TM, but the results are not interchangeable with those obtained with CAT.
BACKGROUND:Thrombin generation assays (TGAs) performed with calibrated automated thrombography (CAT) in the presence of thrombomodulin (TM) indicate plasma hypercoagulability in cirrhosis. OBJECTIVE: To evaluate, in the presence of TM, the new ST-Genesia automated device developed for improving TGA vs the previously used CAT method, with plasma samples of patients with cirrhosis. PATIENTS/ METHODS: Platelet-poor plasma samples were prepared from citrated blood samples of 52 healthy controls and 85 patients with cirrhosis (severity evaluated using the Child-Pugh score [CP]). TGAs were performed using CAT with PPP-Reagent and ST-Genesia with the STG-ThromboScreen reagent, in the presence of TM. Endogenous thrombin potential (ETP) was chosen as the main parameter. RESULTS: Whatever the method, ETP values were higher in patients than in healthy controls. All patients identified as hypercoagulable with ST-Genesia and STG-ThromboScreen were found hypercoagulable with CAT and PPP-Reagent. Conversely, eight and ten patients in the CP-A and CP-B classes respectively were identified as hypercoagulable only with CAT. The use of ST-Genesia with the STG-ThromboScreen reagent with TM led to a bias, with higher ETP values for healthy controls and lower for patients compared with CAT. Crossover analysis (CAT with the STG-ThromboScreen reagent) evidenced a substantial effect of the STG-ThromboScreen reagent; the analyzer (including calibration and data analysis) plays a lesser role. CONCLUSION: ST-Genesia evidences hypercoagulability in patients with cirrhosis when TG is studied in the presence of TM, but the results are not interchangeable with those obtained with CAT.
Authors: Patricia Gomez-Rosas; Marina Pesenti; Cristina Verzeroli; Cinzia Giaccherini; Laura Russo; Roberta Sarmiento; Giovanna Masci; Luigi Celio; Mauro Minelli; Sara Gamba; Carmen Julia Tartari; Carlo Tondini; Francesco Giuliani; Fausto Petrelli; Andrea D'Alessio; Giampietro Gasparini; Roberto Labianca; Armando Santoro; Filippo De Braud; Marina Marchetti; Anna Falanga Journal: TH Open Date: 2021-02-10