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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
Thrombin generation in patients with a first acute myocardial infarction
M Smid1, A W J H Dielis, M Winkens
1Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands. M.Smid@mumc.nl
Journal of Thrombosis and Haemostasis : JTH
|December 15, 2010
Summary
Acute myocardial infarction (AMI) is linked to plasma hypercoagulability. Thrombin generation (TG) testing revealed increased TG parameters in AMI patients, persisting post-event, and identified potential outcome predictors.
Area of Science:
- Cardiology
- Hematology
- Thrombosis Research
Background:
- Myocardial infarction (MI) remains a significant cause of death and disability.
- Plasma hypercoagulability is a contributing factor in acute myocardial infarction (AMI).
Purpose of the Study:
- To investigate hypercoagulability in AMI patients using thrombin generation (TG) testing.
- To evaluate determinants of TG and relate TG parameters to 1-year clinical outcomes.
Main Methods:
- TG testing performed on plasma from 135 AMI patients at admission, day 4, 3 months, and 6 months.
- Multiple regression analysis used to assess coagulation proteins and inhibitors as TG determinants.
- Admission TG results correlated with cardiovascular death, recurrent MI, revascularization (PCI/CABG), and ischemic stroke.
Main Results:
- AMI patients exhibited elevated TG parameters (peak height, endogenous thrombin potential [ETP], lag time) at admission compared to controls.
- Elevated peak height and lag time persisted in patients.
- Combined low ETP and high D-dimer values were associated with adverse outcomes (OR 5.8).
- Tissue factor pathway inhibitor (TFPI) identified as a key TG determinant.
Conclusions:
- TG accurately reflects acute hypercoagulability in AMI, persisting for up to 6 months.
- TG shows a trend towards inverse association with recurrent ischemic cardiovascular events.
- Understanding TG mechanisms can enhance AMI pathophysiology knowledge and guide future medical care improvements.
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