Thrombin generation determined by calibrated automated thrombography (CAT) in pediatric patients with congenital heart disease.
BACKGROUND
Thrombin generation was studied in pediatric patients with congenital heart disease (CHD) undergoing cardiac surgery using the calibrated automated thrombography (CAT) in terms of the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. The possible suitability to determine the coagulation status of these patients was investigated.


METHODS
CAT data of 40 patients with CHD (age range from newborn to 18 years) were compared to data using standard coagulation parameters such as prothrombin (FII), antithrombin (AT), tissue factor pathway inhibitor (TFPI), prothrombin fragment 1.2 (F 1.2), thrombin-antithrombin (TAT), activated partial thromboplastin time (aPTT), and prothrombin time (PT).


RESULTS
A significant positive correlation was seen between ETP and FII (p<0.01; r=0.369), as well as between peak height and F II (p<0.01; r=0.483). A significant negative correlation was seen between ETP and TFPI values (p<0.05; r=-0.225) while no significant correlation was seen between peak height and TFPI. A significant negative correlation was seen between F 1.2 generation and ETP (p<0.05; r=-0.254) and between F 1.2 generation and peak height (p<0.05; r=-0.236). No correlation was seen between AT and ETP or peak.


CONCLUSIONS
Our data indicate that CAT is a good global test reflecting procoagulatory and inhibitory factors of the hemostatic system in pediatric patients with CHD.
Koestenberger
Martin
M
Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Auenbruggerplatz 30, A-8036 Graz, Austria. koestenbergerm@gmx.at
Cvirn
Gerhard
G
Nagel
Bert
B
Rosenkranz
Andrea
A
Leschnik
Bettina
B
Gamillscheg
Andreas
A
Beitzke
Albrecht
A
Muntean
Wolfgang
W
D000293:Adolescent; D000991:Antithrombins / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007700:Kinetics; D010314:Partial Thromboplastin Time; D010446:Peptide Fragments / Q000097:blood; D011517:Prothrombin Time; D013917:Thrombin / Q000096:biosynthesis / Q000378:metabolism*
D000991:Antithrombins; D010446:Peptide Fragments; D013917:Thrombin