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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
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An Evaluation of the Activated Partial Thromboplastin Time Waveform
Takeshi Matsumoto1, Hideo Wada2, Naoki Fujimoto2
11 Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan.
Summary
The activated partial thromboplastin time (APTT) waveform analysis reveals distinct patterns in various diseases. Specific derivative curve (DC) patterns are useful for diagnosing hemophilia, antiphospholipid (aPL) antibodies, and factor VIII (FVIII) inhibitors.
Area of Science:
- Hematology
- Clinical Chemistry
- Diagnostic Medicine
Background:
- The activated partial thromboplastin time (APTT) test is crucial for evaluating the intrinsic pathway of coagulation.
- APTT waveform analysis offers a dynamic view of clot formation, potentially revealing subtle abnormalities.
- Understanding APTT waveform parameters can aid in diagnosing various hemostatic disorders.
Purpose of the Study:
- To investigate the utility of APTT waveform parameters, specifically derivative curves (DC), in differentiating various disease states.
- To identify characteristic APTT waveform patterns associated with hemophilia, antiphospholipid (aPL) antibodies, factor VIII (FVIII) inhibitors, anti-Xa agents, disseminated intravascular coagulation (DIC), and pregnancy.
Main Methods:
- Analysis of APTT waveforms and their first and second derivative curves (DC) in patients with various conditions.
- Measurement of parameters including time to fibrin formation, derivative curve peak heights, and biphasic patterns.
- Comparison of APTT waveform parameters across patient groups (hemophilia, aPL positive, FVIII inhibitors, anti-Xa agents, DIC, pregnant women) and healthy controls.
Main Results:
- A biphasic pattern in the first or second DC was observed in hemophilia, aPL antibody positive patients, and FVIII inhibitor patients.
- Prolonged times for first/second DC and fibrin formation were noted in hemophilia, inhibitors, aPL positive, anti-Xa agent users, and DIC patients.
- Distinct differences in DC peak heights were observed, with lower peaks in hemophilia, inhibitors, aPL positive, and DIC patients, and higher peaks in pregnant women.
Conclusions:
- APTT waveform analysis, particularly the first and second derivative curves, provides valuable diagnostic information.
- Specific waveform patterns and parameter alterations can help identify hemophilia, FVIII inhibitors, and aPL antibodies.
- APTT waveform characteristics differ significantly in pregnancy, suggesting its potential role in monitoring gestational hemostasis.
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