Characterization of Thrombin Generation Curve Shape in Presence of Platelets from Acute Venous Thromboembolism Patients

• Main Authors: Jeremy Lagrange, Bianca Wagner, Markus Nagler, Vincent ten Cate, Alejandro Pallares Robles, Thomas Koeck, Steffen Rapp, Jürgen H. Prochaska, Henri M. Spronk, Philip Wenzel, Wolfram Ruf, Hugo ten Cate, Philipp S. Wild, Marina Panova-Noeva
• Format: Article
• Language: English
• Published: MDPI AG 2020-09-01
• Series: Journal of Clinical Medicine
• Subjects: thrombin generation; venous thromboembolism; platelets; factor Xa inhibitor
• Online Access: https://www.mdpi.com/2077-0383/9/9/2892

<b>Background.</b> Anticoagulant therapy, the cornerstone treatment in acute venous thromboembolism (VTE), strongly impacts thrombin generation (TG). Until now, the appearance of the TG curve in platelet rich plasma (PRP) from patients with acute VTE has not been investigated. <b>Methods.</b> We analyzed the shape of TG curves measured in PARP of 180 acute VTE patients. <b>Results.</b> Normal shape of TG curves was observed in 110 patients, 50 patients showed no TG and 20 patients showed biphasic TG curve. The linear regression analysis, adjusted for age, sex, VTE clinical phenotypes and therapy showed that the appearance of biphasic curves is significantly associated with female sex, presence of cancer and therapy with Factor Xa inhibitors. <b>Conclusions.</b> This study demonstrated that despite taking anticoagulants, TG in presence of platelets is still present in the majority of acute VTE patients. Appearance of unusual TG curves is strongly related to the intake of anti-Factor Xa inhibitors. The clinical relevance of biphasic TG curve appearance requires further investigation.