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Table 3 Examples of Trombin generation response to different procoagulant states

From: Global assays of hemostasis in the diagnostics of hypercoagulation and evaluation of thrombosis risk

Procoagulant state

Number of patients in study group

TG trigger and additional substances

Data range in control group, mean ± SD unless otherwise indicated

Data range in group with hypercoagulation, mean ± SD unless otherwise indicated

Significance

Predictive value

Reference

Comments

Recurrence after first unprovoked VTE

254 – with a first VTE, 34 - with recurrence

1 pM TF 1 uM PL

ETP, nM∙min 1502 ± 446

ETP, nM∙min 1361 ± 499

0.122

1 tertile compared to the 3 HR = 2.54

[68]

Prospective study. Analysis was performed 2-3 months after completion of anticoagulant therapy.

IIa max, nM 232 ± 82

IIa max, nM 187 ± 89

0.005

HR = 3.09

Tlag, min 12 ± 6

Tlag, min 13 ± 5

0.319

HR = 2.29

 

1 pM TF 1 uM PL 4 nM TM

ETP, nM∙min 986 ± 422

ETP, nM∙min 763 ± 468

0.009

HR = 3.35

[68]

 

IIa max, nM 201 ± 75

IIa max, nM 148 ± 88

<0.001

HR = 4.49

Tlag, min 17 ± 7

Tlag, min 19 ± 10

0.174

HR = 2.39

Unprovoked recurrence after first VTE

188 with a first VTE, 29 – with recurrence

5 pM TF 4 uM PL

   

ETP > 50th percentile HR = 2.9

[69]

Prospective study. Analysis was performed 2-3 months after completion of anticoagulant therapy.

 

5 pM TF 4 uM PL 8nM TM

   

No significant predictive value

[69]

 

Recurrence after first unprovoked VTE

914 with a first VTE, 100 – with recurrence

72 pM TF 3.2 uM PL

IIa max, nM 349 ± 108

IIa max, nM 419 ± 110

<0.001

IIa max >400 nM RR = 2.5

[70]

Prospective study. Analysis was performed after completion of anticoagulant therapy.

First and recurrent VT

187 with a first unprovoked VT 404 controls

1/6 deluted plasma 2.5 pM TF 4 uM PL 1.2 nM TM

Mean ETP(95% CI), nM∙min 1641 (1607 -1676)

Mean ETP(95% CI), nM∙min 1695(1639–1750)

 

ETP > 90th percentile measured in control subjects DVT HR = 1.7

[71]

Analysis was performed 3 months after completion of anticoagulant therapy.

173 with a first provoked VT 404 controls

 

Mean ETP(95% CI), nM∙min 1641 (1607 -1676)

Mean ETP(95% CI), nM∙min 1649(1595-1703)

  

[71]

 

59 recurrent VTE

    

HR of recurrence 1.1

[71]

 

Recurrence after first unprovoked VTE

105 with a first VTE, 40 – with recurrence

5 pM TF 4 uM PL

ETP, nM∙min 1671 ± 514

ETP, nM∙min 1491 ± 536

0.111

 

[72]

Prospective study. Analysis was performed upon diagnosis of VTE

IIa max, nM 302 ± 91

IIa max, nM 261 ± 125

0.058

Tlag, min 7.2 ± 2.2

Tlag, min 8.7 ± 5

<0.001

Acute Ischemic Stroke (men)

42 patients 408 controls

5 pM TF 4 uM PL

geometric mean and interquartile range ETP, nM∙min 1755 (1620 - 1940)

geometric mean and interquartile range ETP, nM∙min 1720 (1572 - 1978)

 

HR = 0.88/sd

[74]

Prospective study.

IIa max, nM 327.0 (304.9 - 357.8)

IIa max, nM 330.2 (301.8 - 361.4)

 

HR = 1.04/sd

Acute Ischemic Stroke (women)

45 patients 666 controls

5 pM TF 4 uM PL

ETP, nM∙min 1755 (1604 - 1940)

ETP, nM∙min 1863 (1636 -1998)

 

HR = 1.55/sd

[74]

Prospective study

IIa max, nM 333.6 (311.0 - 372.4)

IIa max, nM 357.8 (320.5 - 391.5)

 

HR = 1.71/sd

Coronary Heart Disease events

186 patients 1000 controls

5 pM TF 4 uM PL

ETP, nM∙min 1765 (1620 - 1940)

ETP, nM∙min 1772 (1604- 1939

 

HR = 1.09/sd

[74]

Prospective study

IIa max, nM 333.0 (308.0 - 365.0)

IIa max, nM 330.3 (301.9- 357.8)

 

HR = 1.02/sd IIa max

Prothrombin G20210A mutation

148 heterozigote, 111 - controls

6.8 pM TF 30 uM PL

median and interquartile range ETP, nM∙min 1053 (946–1171)

median and interquartile range ETP, nM∙min 1358 (1190–1492)

the carriers as opposed to the non-carriers <0.001

 

[75]

 

IIa max, nM 292 (267–330)

IIa max, nM 349 (307–385)

<0.001

Tlag, min 2.54 (2.46–2.84)

Tlag, min 2.74 (2.46–3.04)

0.268

3 homozigote

 

ETP, nM∙min 1661 (1451–1976)

  

[75]

 

IIa max, nM 466 (446–470)

Tlag, min 3.06 (2.14–5.08)

AT III-inherited deficiency

9 - controls 18 Type I-IIRS/PE

5 pM TF 4 uM PL

ETP, nM∙min 2200 ± 320

ETP, nM∙min 3366 ± 668

Only Type I-IIRS/PE end controls ETP differs significantlly

 

[76]

 

IIa max, nM 377.3 ± 49.1

IIa max, nM 493.4 ± 75.0

17 -IIHBS heterozygote

 

ETP, nM∙min 2142 ± 464

IIa max, nM 427.2 ± 98.3

8 - Cambridge II heterozygote

 

ETP, nM∙min 2211 ± 268

IIa max, nM 391.4 ± 46.8

VTE in cancer patients

1033 cancer patients 77 VTE cases

71.6 pM TF 3.2 uM PL

median (25th to 75th percentile) ETP, nM∙min 4386 (3804-4890)

median (25th to 75th percentile) ETP, nM∙min 4475 (4087-4915)

0.197

IIa max > 611 nM (75th percentile) HR = 2.1

[80]

Prospective study

IIa max, nM 499 (360-603)

IIa max, nM 556 (432-677)

0.014

Type 2 diabetes mellitus

52 patients, 60 controls

1 pM TF 1 uM PL

Median (range) ETP, nM∙min 1844 (1,317–2592)

Median (range) ETP, nM∙min 1835 (1213–2656)

0.96

 

[55]

 

IIa max, nM 264 (97–432)

IIa max, nM 303 (207–434)

<0.001

Tlag, min 7.8 (4.7–18.4)

Tlag, min 5.9 (4.5–11.5)

<0.001

1 pM TF 1 uM PL 4 nM TM

ETP, nM∙min 1301 (535–2381)

ETP, nM∙min 1497 (1061–2418)

0.003

 

[55]

 

IIa max, nM 256 (79–433)

IIa max, nM 297 (216–427)

0.001

Tlag, min 10.4 (6.3–25.8)

Tlag, min 7.8 (5.6–13.6)

<0.001

43 patients, 60 controls

Ca only

ETP, nM∙min 1678 (539–2231)

ETP, nM∙min 1781 (288–2598)

0.05

 

[55]

 

IIa max, nM 151 (41–289)

IIa max, nM 202 (128–350)

<0.001

Tlag, min 12.6 (7.0–29.5)

Tlag, min 10.8 (7.2–16.1)

<0.001

Diabetes mellitus

89 patients

49 controls

5 pM TF 4 uM PL

ETP, nM∙min 1566.4 ± 240.7

ETP, nM∙min 1876.5 ± 390.0

<0.001

 

[62]

 

IIa max, nM 252.8 ± 44.6

IIa max, nM 308.9 ± 39.5

<0.001

Tlag, min 4.15 ± 0.74

Tlag, min 3.59 ± 0.62

<0.001

Normal pregnancy

19 health pregnant women 

10 controls

5 pM TF 20 uM PL 0.1 mg/ml CTI

ETP, nM∙min 1553 ± 567

pre-pregnancy ETP, nM∙min 1162 ± 446

Significant difference between pre-pregnancy and early/late pregnancy P < 0.001

 

[82]

 

IIa max, nM 81 ± 41

Early

ETP, nM∙min 2157 ± 466

IIa max, nM 159 ± 100

IIa max, nM 219 ± 117

Late ETP, nM∙min 2410 ± 543

IIa max, nM 336 ± 178

Normal pregnancy

1st Trimester (n = 36)

5 pM TF 4 uM PL

TG on normal pooled plasma was significantly lower than TG on pregnant women. The exact parameter’s values weren’t shown

ETP, nM∙min 2123 ± 335

No significant differences between trimesters

 

[83]

 

IIa max, nM 366 ± 43

2nd Trimester (n = 42)

ETP, nM∙min 2067 ± 326

IIa max, nM 374 ± 42

3rd Trimester (n = 23)

ETP, nM∙min 1915 ± 261

IIa max, nM 336 ± 49