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The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well
Published on: February 27, 2026
Age-dependency of thrombin generation measured by means of calibrated automated thrombography (CAT)
Harald Haidl1, Christina Cimenti, Bettina Leschnik
1Ludwig Boltzmann Research Institute for Paediatric Thrombosis and Haemostasis, Auenbruggerplatz 30, 8036 Graz / Styria.
Insights
Thrombin generation, a measure of overall hemostasis, is age-dependent in both children and adults. This finding is crucial for interpreting results from thrombin generation tests and understanding thrombosis risk across different age groups.
Area of Science:
- Hematology
- Hemostasis and Thrombosis
- Pediatric Coagulation
Background:
- Coagulation parameters like PT and aPTT exhibit age-dependency.
- Thrombin generation may offer a more comprehensive reflection of overall hemostasis.
- Investigating age-related changes in thrombin generation is essential for clinical interpretation.
Purpose of the Study:
- To determine if thrombin generation, measured by calibrated automated thrombography (CAT), demonstrates age-dependency.
- To compare thrombin generation parameters across various pediatric and adult age groups.
- To assess the clinical implications of age on thrombin generation measurements.
Main Methods:
- Thrombin generation was assessed in platelet-poor plasma from 121 children and 86 adults using calibrated automated thrombography (CAT).
- Correlation analysis was performed to evaluate the relationship between age and thrombin generation parameters (ETP, lag time, peak, time to peak).
- The Mann-Whitney-U-Test was used to compare thrombin generation between different age cohorts.
Main Results:
- Endogenous thrombin potential (ETP), lag time, peak, and time to peak showed significant correlations with age (p < 0.01).
- Children and adolescents consistently exhibited lower ETP values compared to adults.
- Age-specific differences in lag time, peak, and time to peak were observed across pediatric groups and between adult groups.
Conclusions:
- Thrombin generation exhibits significant age-dependency, extending beyond the juvenile period into adulthood.
- Age must be considered when utilizing thrombin generation measurements in routine clinical practice.
- The observed age-related changes in thrombin generation align with the increased incidence of thrombotic events in older individuals.
Abstract:
Many coagulation parameters, such as PT or aPTT, show age-dependency. In this study we investigated if the generation of thrombin, possibly better reflecting overall haemostasis, shows an age-dependency. Thrombin generation was measured in platelet poor plasma of 121 children and 86 adults at different ages by means of calibrated automated thrombography (CAT). Correlation analysis shows that endogenous thrombin potential (ETP) (r = 0.702), lag time (r = -0.266), peak (r = 0.533) and time to peak (r = -0.214) are significantly correlated with age (p < 0.01). 'Younger' (age limit 35 years) and 'older' adults were compared with groups of children and adolescent aged between 0.5 and 6 years, 7 and 11 years and 12 to 17 years by means of the Mann-Whitney-U-Test. ETP values of all children and adolescents were significantly lower than those of adults. In the group of the youngest children, additionally shorter lag times and times to peak and lower peak levels differed significantly from those of adults. In the group of 7- to 11-year-old children, lag times were significantly longer than those of both groups of adults, while lower peaks and longer times to peak differed only from the group of the 'older' adults. In the group of the 12- to 17-year-olds, the values of ETP were lower than those of adults. In addition, both adult groups differed significantly in all studied parameters. Our results show an age-dependency of thrombin generation even beyond the juvenile period. If thrombin generation measurement is to be used as a routine method, age has to be considered. Assuming that thrombin potential is an indicator for the risk of thrombosis, our findings are in accordance with the observation of an increased incidence of thrombembolic disease with higher age.
