Thrombin generation: What have we learned?

Dieri, Raed Al; Laat, Bas de; Hemker, H.C.

doi:10.1016/j.blre.2012.06.001

Cited by 150 publications

(166 citation statements)

References 113 publications

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“…Automated in vitro thrombin generation is a relatively new technique that can be expected to yield more information in the years to come. Thrombin generation in platelet‐rich plasma—a very useful technique for the study of the interplay between platelets and clotting factors87—has not as yet been clinically explored to any significant extent. This seems pertinent now that millions of patients are being exposed to direct oral thrombin (formation) inhibitors (non–vitamin K oral anticoagulants)!…”

Section: Conclusion and Suggested Avenues For Researchmentioning

confidence: 99%

Thrombin Generation and Atherothrombosis: What Does the Evidence Indicate?

Cate

Hemker

2016

JAHA

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Section: Conclusion and Suggested Avenues For Researchmentioning

confidence: 99%

Thrombin Generation and Atherothrombosis: What Does the Evidence Indicate?

Cate

Hemker

2016

JAHA

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“…TG is more informative than conventional clotting assays, which only reflect a small part of the coagulation process; more than 95% of all thrombin is formed after the initiation phase, when plasma has already clotted. In contrast, in TG measured by calibrated automated thrombinography (CAT) the entire process of the formation of the bulk of thrombin via feedback on factors V, VIII, and XI, as well as the effects of anticoagulant pathways and thrombin inhibition by protease inhibitors is visualized in the thrombogram 7, 8. Therefore, in the current study we used a modified TG assay to assess the variability of saliva‐induced TG in a healthy population.…”

Section: Introductionmentioning

confidence: 99%

Salivary tissue factor induces thrombin generation in a diurnal rhythm

Vorm

Brouwers²,

Mondria

et al. 2018

Research and Practice in Thrombosis and Haemostasis

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BackgroundUpon tooth extraction, extravascular tissue factor (TF) initiates coagulation to arrest bleeding. Additionally, saliva is in constant contact with the wound and contains extracellular vesicle‐derived procoagulant TF. Since the duration of postextraction bleeding is highly variable between patients, we hypothesized this may be caused by variation in saliva‐derived TF‐induced clotting activity.ObjectivesWe aimed to assess the variability of saliva‐induced thrombin generation (TG) in healthy individuals.Methods TG was performed according to the calibrated automated thrombinography (CAT) method. Diluted saliva was added (instead of recombinant TF and phospholipids [PL]) to normal pooled plasma (NPP) in the absence/presence of anti‐TF antibodies. Saliva was collected from healthy individuals in the morning, afternoon and evening.ResultsAddition of saliva to NPP induced TG curves similar to those induced by r‐TF and PL. Moreover, addition of anti‐TF antibodies abolished saliva‐induced TG, indicating TF‐dependence. A large inter‐individual variability (peak CV 31%, range 73‐220 nmol/L thrombin) in saliva‐induced TG was observed. Interestingly, within subjects, saliva‐induced TG was significantly (P = 0.009) increased in the morning (167 ± 40 nmol/L thrombin) compared to the afternoon (124 ± 39 nmol/L thrombin) and evening (123 ± 38 nmol/L thrombin). This diurnal variation was not attributable to gingival stimulation or damage induced by tooth brushing.ConclusionsWe identified a diurnal rhythm in salivary TF activity that may have implications for tooth extraction and dental surgery, as performing invasive procedures in the morning may be beneficial for rapid coagulation. Future studies should correlate salivary TF to clinical outcome (ie, postextraction bleeding) and assess a possible relation with bacterial status in the oral cavity.

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“…Whether or not fluorogenic substrate ZGGR-AMC offers the option to determine thrombin potential from samples containing erythrocytes has recently come under debate [4,5,6,7]. Ramjee [8] published an article suggesting the fluorogenic substrate ZGGR-AMC enabled coagulation to be measured from whole blood (WB), PRP and PPP.…”

Section: Tablementioning

confidence: 99%