[Usefulness of the thrombin generation test in hypercoagulability states]

Thrombin is one of the key components of the hemostatic system. The thrombin generation assay (TGA) assesses the activation, propagation and inhibition of coagulation. This global coagulation test is of interest for assessing the risk of bleeding and thrombosis. Numerous studies have been performed in the "thrombophilia". We performed a systematic review of studies on thrombinography in thrombophilia. The included studies, published in English, were original investigations using TGT during venous thromboembolic disease, arterial occlusive pathology, pregnancy, anti-phospholipid syndrome, constitutional thrombophilias, or oncology. Eighty studies were selected between January 2003 and June 2022. Most had fewer than 100 patients. The only two studies that included more than 1000 patients showed an increased risk of thrombotic recurrence or increased mortality from cardiovascular disease associated with increased thrombin generation. All "thrombophilia" have been studied, but lack of standardization between conditions has limited the development of clinical research with this assessment technique. Harmonization of practices may provide more relevant systems for predicting the occurrence of arterial or venous thrombotic events.