title: Dynamic APTT parameters: applications in thrombophilia.
abstract: BACKGROUND
  Patients with a history of venous thrombosis occasionally have shortened APTTs when compared with those of healthy references, but the clinical applicability of a shortened APTT is limited.
  
  
  OBJECTIVE
  The present study aimed to characterize dynamic APTT profiles in patients with previously documented venous thrombosis and hypothesized that the APTT-MaxVel was significantly elevated in patients with a history of venous thrombosis as compared with healthy controls.
  
  
  METHODS
  We performed a case control study, enrolling a total of 38 patients, 17 males and 21 females, with a verified recent venous thrombotic event, as well as 88 healthy controls. Fifty-three per cent of patients were found to have a biochemical risk factor. A standard APTT was recorded in platelet-poor plasma, and the digital clotting signal was processed using simple algorithms developed to derive dynamic coagulation parameters.
  
  
  RESULTS
  Patients had a significantly higher mean APTT-MaxVel (195.5 s(-1) ; SD = 57; 95% CI, 176.8-214.1) as compared with healthy controls (137.3 s(-1) ; SD = 21; 95% CI, 130.7-143.8). Patients also had significantly shorter mean APTTs (26.9 s; SD = 3.2; 95% CI, 25.9-28.0) than healthy controls (28.5 s; SD = 2.8; 95% CI, 27.9-29.0). While only one out of 38 patients (2.6%) had a standard APTT below the lower reference interval, 15 of the 38 patients (38.5%) had an APTT-MaxVel above the upper reference limit. Regression analysis revealed linear correlation between FVIII:C, the level of fibrinogen and APTT-MaxVel (R(2) = 0.89, P < 0.05).
  
  
  CONCLUSIONS
  Simple signal processing of the APTT and the use of dynamic parameters represents a stronger predictive marker for hypercoagulation in patients with verified venous thrombosis than the standard APTT measurement.
authors.affiliation: Haemostasis Research Unit, Centre for Haemostasis and Thrombosis, Guy's and St Thomas' NHS Foundation & King's College London School of Medicine, London, UK. benny.sorensen@kcl.ac.uk
authors.forename: B
authors.initials: B
authors.lastname: Sørensen
authors.forename: J
authors.initials: J
authors.lastname: Ingerslev
mesh_terms: D000328:Adult; D000465:Algorithms; D001777:Blood Coagulation; D003718:Denmark; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time / Q000592:standards; D011237:Predictive Value of Tests; D012372:ROC Curve; D012015:Reference Standards; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis*; D013997:Time Factors; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis*