Thrombin generation assay in venous thromboembolism: A scoping review

To describe the relationship, through a scoping review, between thrombin generation assay (TGA) parameters and venous thromboembolism (VTE).

A systematic search was carried out in the PubMed/MEDLINE, Embase, Cochrane, Virtual Health Library, Web of Science, and Scopus databases using descriptors for VTE and thrombin generation. Human studies assessing the association between TGA parameters and the occurrence of VTE were included. Screening of the title/abstract and full text was carried out independently by two researchers and divergent classifications were resolved by a third examiner.

5204 studies were found, of which 90 were included after screening and full reading. The articles were grouped according to the study population and the factors associated with VTE: unprovoked VTE [33], cancer [20], hereditary/acquired thrombophilias [12], trauma/hospitalization [11], use of hormone replacement therapy/combined oral contraceptives [6], pregnancy [4] and use of anticoagulants [4]. The studies included were predominantly conducted in European countries between 2001 and 2024. Most of the studies were prospective cohort studies and used the Calibrated Automated Thrombogram (CAT) method to perform the TGA. The TGA parameters evaluated were mainly ETP and peak, which were elevated in patients with VTE in all the subgroups assessed. The TGA was able to predict the risk of primary and recurrent VTE and proved to be a useful tool for managing therapeutic regimens with anticoagulants in patients who suffered VTE.

The included studies demonstrated that TGA is a promising test in the context of VTE.