title: The routine determination of the endogenous thrombin potential, first results in different forms of hyper- and hypocoagulability.
abstract: The area under the thrombin generation curve (the endogenous thrombin potential; ETP) has been proposed as a parameter for plasma-based hypercoagulability and to monitor anticoagulant treatment. We present an ETP assay for the routine laboratory using a centrifugal analyser. Throughput is 30 samples/h, within and between run imprecision is 4-5.6%. Suitable substrates were developed for the ranges of 10-500% and 2-100% of normal. Independent of tissue factor concentration (if > 4 pM), the normal value of the extrinsic ETP is 384.8 +/- 51.7 nM.min. The intrinsic ETP, triggered by ellagic acid, is 414 +/- 41 nM.min. The ETP is decreased to 15 and 35% of normal by oral anticoagulation (INR 2.5-4.0) and by heparin administration (APTT 1.5-2.5 x control). The ETP is increased in untreated subjects with congenital antithrombin deficiency and in women using oral contraceptives. In deep vein thrombosis (phlebographically confirmed), it is increased by 29.4% (extrinsic) and 53% (intrinsic). In (angiographically assessed) coronary artery disease the increase is by 10% and 17% respectively.
authors.affiliation: Department of Biochemistry, Medical Faculty and Cardiovascular Research Institute, Maastricht University, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Wielders
authors.forename: M
authors.initials: M
authors.lastname: Mukherjee
authors.forename: J
authors.initials: J
authors.lastname: Michiels
authors.forename: D T
authors.initials: DT
authors.lastname: Rijkers
authors.forename: J P
authors.initials: JP
authors.lastname: Cambus
authors.forename: R W
authors.initials: RW
authors.lastname: Knebel
authors.forename: V
authors.initials: V
authors.lastname: Kakkar
authors.forename: H C
authors.initials: HC
authors.lastname: Hemker
authors.forename: S
authors.initials: S
authors.lastname: Béguin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D019540:Area Under Curve; D001778:Blood Coagulation Disorders / Q000097:blood*; D003955:Diagnostic Tests, Routine; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D015203:Reproducibility of Results; D013917:Thrombin / Q000096:biosynthesis*; D013925:Thromboplastin / Q000378:metabolism; D013927:Thrombosis / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D013925:Thromboplastin; D013917:Thrombin