title: Thrombin generation: a comparison of assays using platelet-poor and -rich plasma and whole blood samples from healthy controls and patients with a history of venous thromboembolism.
abstract: We have developed a whole blood thrombin generation (TG) assay whereby TG is initiated with a low-tissue factor concentration and monitored using a fluorogenic thrombin substrate. Significantly higher values were found in blood samples from 50 patients with a history of venous thromboembolism (VTE) compared with 31 healthy controls (HC), for peak height (P = 0.0034) and endogenous thrombin potential (ETP) (P = 0.0027). Results from 31 VTE patients and the 31 controls in the absence of corn trypsin inhibitor (CTI) showed significantly higher values in the VTE group for peak height (P = 0.0013) and ETP (P = 0.002). In the presence of CTI, significantly higher values were only seen in ETP (P = 0.024). No significant increases in TG were found using platelet poor (PPP) or -rich (PRP) plasma with or without CTI. The whole blood TG assay in the absence or presence of CTI showed a higher proportion (25/50 and 12/31, respectively) of raised peak height and/or ETP values than plasma assays (PPP 9/50 and 5/31 respectively and PRP 13/50 and 6/31, respectively). Our results show the whole blood TG assay is more sensitive for determining the increases in TG in patients with a history of VTE than PPP and PRP TG assays.
authors.affiliation: Department of Biosciences, University of Kent and Ken Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, Kent, UK. kerry.tappenden@ekht.nhs.uk
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Tappenden
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gallimore
authors.forename: Gillian
authors.initials: G
authors.lastname: Evans
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Mackie
authors.forename: David W
authors.initials: DW
authors.lastname: Jones
mesh_terms: D000328:Adult; D001780:Blood Coagulation Tests; D001792:Blood Platelets / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma; D053657:Platelet-Rich Plasma; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013917:Thrombin / Q000096:biosynthesis*; D013923:Thromboembolism / Q000097:blood*; D014361:Trypsin Inhibitors / Q000494:pharmacology
chemical_list: D014361:Trypsin Inhibitors; D013917:Thrombin