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Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets
Platelet-dependent thrombin generation is a helpful tool to assess ex vivo the interaction between platelets and plasma coagulation factors in the initiation, amplification, and inhibition of thrombin generation (TG). This review article discusses the most relevant available data on the clinical app...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019916/ https://www.ncbi.nlm.nih.gov/pubmed/31905839 http://dx.doi.org/10.3390/jcm9010092 |
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author | Panova-Noeva, Marina van der Meijden, Paola E.J. ten Cate, Hugo |
author_facet | Panova-Noeva, Marina van der Meijden, Paola E.J. ten Cate, Hugo |
author_sort | Panova-Noeva, Marina |
collection | PubMed |
description | Platelet-dependent thrombin generation is a helpful tool to assess ex vivo the interaction between platelets and plasma coagulation factors in the initiation, amplification, and inhibition of thrombin generation (TG). This review article discusses the most relevant available data on the clinical applications of fluorogenic TG, the most widely used TG assay, performed in the presence of platelets, i.e., in platelet-rich plasma. With respect to prothrombotic states, arterial hypertension and obesity were the most prominent cardiovascular conditions linked to increased platelet-dependent TG. In addition, platelet-associated hypercoagulability, assessed by the TG assay, has been shown in individuals with active cancer. In terms of bleeding, platelet-dependent TG has been applied to assess bleeding risk in individuals with hemophilia, von Willebrand disease, and Glanzmann thrombasthenia as well as in subjects with other congenital or acquired coagulation factor deficiencies. In addition to risk prediction, a role of the TG assay has been suggested in monitoring antiplatelet therapy in prothrombotic conditions and replacement therapy in bleeding diathesis. Finally, for the routine clinical use and as a biomarker of disease development and progression, better standardization and clinical validation of platelet-dependent TG are still needed. |
format | Online Article Text |
id | pubmed-7019916 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-70199162020-03-09 Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets Panova-Noeva, Marina van der Meijden, Paola E.J. ten Cate, Hugo J Clin Med Review Platelet-dependent thrombin generation is a helpful tool to assess ex vivo the interaction between platelets and plasma coagulation factors in the initiation, amplification, and inhibition of thrombin generation (TG). This review article discusses the most relevant available data on the clinical applications of fluorogenic TG, the most widely used TG assay, performed in the presence of platelets, i.e., in platelet-rich plasma. With respect to prothrombotic states, arterial hypertension and obesity were the most prominent cardiovascular conditions linked to increased platelet-dependent TG. In addition, platelet-associated hypercoagulability, assessed by the TG assay, has been shown in individuals with active cancer. In terms of bleeding, platelet-dependent TG has been applied to assess bleeding risk in individuals with hemophilia, von Willebrand disease, and Glanzmann thrombasthenia as well as in subjects with other congenital or acquired coagulation factor deficiencies. In addition to risk prediction, a role of the TG assay has been suggested in monitoring antiplatelet therapy in prothrombotic conditions and replacement therapy in bleeding diathesis. Finally, for the routine clinical use and as a biomarker of disease development and progression, better standardization and clinical validation of platelet-dependent TG are still needed. MDPI 2019-12-30 /pmc/articles/PMC7019916/ /pubmed/31905839 http://dx.doi.org/10.3390/jcm9010092 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Panova-Noeva, Marina van der Meijden, Paola E.J. ten Cate, Hugo Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets |
title | Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets |
title_full | Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets |
title_fullStr | Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets |
title_full_unstemmed | Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets |
title_short | Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets |
title_sort | clinical applications, pitfalls, and uncertainties of thrombin generation in the presence of platelets |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019916/ https://www.ncbi.nlm.nih.gov/pubmed/31905839 http://dx.doi.org/10.3390/jcm9010092 |
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