Thrombodynamics, a new global coagulation test: Measurement of heparin efficiency

Abstract

The actual coagulation status may be reliably measured using only highly sensitive global functional tests; however, they are not numerous and all of them have disadvantages. Thrombodynamics (TD), a novel global coagulation test, is sensitive to hypo- and hypercoagulable states. The main properties of this test were investigated, and its capabilities for hemostasis analysis were verified through pharmacodynamic monitoring of the most widely used anticoagulants, heparins. The anticoagulant effects in the plasma of donors (n = 20) and patients after hip replacement (n = 20) spiked with unfractionated heparin or enoxaparin were measured in vitro to eliminate the influence of pharmacokinetic factors. Sensitivity for heparins was compared for activated partial thromboplastin time, thrombin generation tests and TD. TD was shown to reliably characterize the pharmacodynamics of any heparin in the entire range of its prophylactic and therapeutic concentrations. Inter-individual variability for the anticoagulant action of heparins was also calculated using the TD data. This variability did not differ between the investigated groups and did not exceed 12% and 20% for the stationary clot growth rate in the presence of unfractionated heparin and enoxaparin, respectively. That finding was in accordance with the values determined earlier using the thrombin generation test. The study results showed that TD has advantages over the other global methods of coagulation analysis. These advantages are good standardization, high reproducibility, independence of the parameter values from patient age and gender, and a narrower parameter distribution in a normal population. These results indicate that TD is a promising universal assessment method that improves the quality of hemostasis analysis because it more reliably detects deviations from the parameters' reference values.

Examination of Laboratory for Monitoring Heparin Anticoagulant Therapy

“…Research by Sinauridze et al measure Tlag, Vi, and V parameters in post hip surgery patients who get heparin. The result is only Vi and V have significant different results, whereas Tlag has results that are not much different before and after heparin is given [44].…”

“…Other important parameters that are also measured are the maximum optical density of the formed clot (D) which shows the quality of the clot and the time required for the appearance of spontaneous clot (Tsp). The last two parameters have important clinical values because spontaneous clot (which grows not from activators on the surface) is only found in serious hypercoagulability states [44].…”

“…(b) Photos of the sequence of clot growth from spontaneous activator in vitro and clot in a portion of the sample. (c) Schematic image of clot growth from damage to blood vessel walls in vivo[44].…”

Platelet, erythrocyte, endothelial, and monocyte microparticles in coagulation activation and propagation

“…The procoagulant activity of MPs was studied using the Thrombodynamics test. The assay is described in [33–35]. A total of 107 µl of MP-poor plasma was supplemented with 13 µl of MPs in different concentrations or buffer A.…”

The venous thromboembolism safety zone project: the results from an obstetric focus-group study

“…Сделаны выводы об отсутствии необходимости лабораторного мониторинга при приеме НМГ. В то же время предпринимаются попытки контролировать НМГ у беременных с помощью глобальных тестов оценки системы гемостаза -тромбоэластографии и тромбодинамики [12][13][14].…”