Semi-automated thrombin dynamics applying the ST Genesia thrombin generation assay

Area of Science:

• Biochemistry
• Hematology
• Clinical Chemistry

Background:

• Hemostasis relies on a balance between procoagulant and anticoagulant factors.
• Thrombin generation (TG) is central to coagulation, making its measurement crucial for identifying bleeding or thrombotic risks.
• Analyzing thrombin dynamics (TD) offers deeper insights into thrombin formation and inactivation processes.

Purpose of the Study:

• To establish reference values for thrombin dynamics (TD) analysis.
• To utilize an automated system for measuring thrombin generation (TG) in 112 healthy donors.
• To investigate the relationship between prothrombin conversion, thrombin inactivation, and hemostatic factors.

Main Methods:

• Thrombin generation (TG) was measured using the ST Genesia automated system.
• Plasma levels of fibrinogen, anti-thrombin (AT), and α2-macroglobulin (α2M) were quantified.
• Thrombin dynamics (TD) analysis was performed using TG data combined with plasma factor levels.

Main Results:

• Increased tissue factor (TF) concentration led to higher prothrombinase complex maximum rate (PCmax) and total prothrombin converted (PCtot).
• Thrombin-AT and Thrombin-α2M complex formation also increased with TF concentration.
• Women using oral contraceptives showed higher PCtot, PCmax, T-AT, and T-α2M levels, with reduced thrombomodulin inhibition compared to others.

Conclusions:

• Automated TG measurements are suitable inputs for TD analysis.
• The established reference values for TD analysis can be applied in future clinical studies.
• Understanding the balance between prothrombin conversion and thrombin inactivation is clinically valuable.