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Thrombin generation in paediatric patients with congenital heart disease. Determination by calibrated automated
M Koestenberger1, G Cvirn, A Rosenkranz
1Department of Paediatrics, Medical University Graz, Auenbruggerplatz 30, 8036 Graz, Austria. koestenbergerm@gmx.at
Insights
Calibrated automated thrombography (CAT) effectively assesses coagulation in pediatric congenital heart disease patients. This global test reflects key procoagulant and anticoagulant factors, aiding in determining their hemostatic status.
Area of Science:
- Pediatric cardiology
- Hemostasis and thrombosis
- Coagulation diagnostics
Background:
- Congenital heart disease (CHD) in children presents complex hemostatic challenges.
- Assessing the coagulation status in these patients is crucial for surgical management.
- Standard coagulation tests may not fully capture the dynamic nature of thrombin generation.
Purpose of the Study:
- To investigate the utility of calibrated automated thrombography (CAT) in evaluating thrombin generation.
- To determine the suitability of CAT for assessing the coagulation status in pediatric patients with CHD undergoing cardiac surgery.
- To correlate CAT parameters with standard coagulation markers.
Main Methods:
- Calibrated automated thrombography (CAT) was employed to analyze thrombin generation parameters.
- Parameters measured included lag time, time to peak, endogenous thrombin potential (ETP), and peak height.
- CAT data from 40 pediatric CHD patients were compared with standard coagulation tests (FII, AT, TFPI, F 1.2, TAT, aPTT, PT).
Main Results:
- Significant positive correlations were observed between ETP and prothrombin (FII), and between peak height and FII.
- A significant negative correlation was found between ETP and tissue factor pathway inhibitor (TFPI).
- Negative correlations were noted between F 1.2 generation and both ETP and peak height, indicating complex interactions within the coagulation system.
Conclusions:
- Calibrated automated thrombography (CAT) serves as a valuable global test for assessing hemostasis in pediatric patients with CHD.
- CAT effectively reflects both procoagulatory and inhibitory factors of the hemostatic system.
- The findings support the use of CAT for a comprehensive evaluation of coagulation status in this population.
Unlabelled:
Thrombin generation was studied in paediatric patients with congenital heart disease (CHD) undergoing cardiac surgery using the calibrated automated thrombography (CAT) in terms of the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. The suitability to determine the coagulation status of these patients was investigated.
Patients, Material, Methods:
CAT data of 40 patients with CHD (age range from newborn to 18 years) were compared to data using standard coagulation parameters such as prothrombin (FII), antithrombin (AT), tissue factor pathway inhibitor (TFPI), prothrombin fragment 1.2 (F 1.2), thrombin-antithrombin (TAT), activated partial thromboplastin time (aPTT), and prothrombin time (PT).
Results:
A significant positive correlation was seen between ETP and FII (p < 0.01; r = 0.369), as well as between peak height and FII (p < 0.01; r = 0.483). A significant negative correlation was seen between ETP and TFPI values (p < 0.05; r = -0.225) while no significant correlation was seen between peak height and TFPI. A significant negative correlation was seen between F 1.2 generation and ETP (p < 0.05; r = -0.254) and between F 1.2 generation and peak height (p < 0.05; r = -0.236). No correlation was seen between AT and ETP or peak.
Conclusions:
CAT is a good global test reflecting procoagulatory and inhibitory factors of the haemostatic system in paediatric patients with CHD.
