Key result
A low response to thrombomodulin, defined as a TACT ratio below the 10th percentile, was significantly associated with deep venous thrombosis (OR 3.5; 95% CI 1.7-7.2).
Why the study?
Does the newly developed thrombomodulin addition clotting time (TACT) assay detect a lower anticoagulant response to thrombomodulin in patients with deep venous thrombosis compared to matched controls?
Case-Control (n=206)
Does the newly developed thrombomodulin addition clotting time (TACT) assay detect a lower anticoagulant response to thrombomodulin in patients with deep venous thrombosis compared to matched controls?
Odds Ratio: 3.5 (95% CI 1.7–7.2)
Absolute Event Rate: 29% vs 10%
A newly developed TACT assay reveals that patients with DVT have a significantly reduced anticoagulant response to thrombomodulin compared to healthy controls, independent of natural anticoagulant deficiencies.
May identify thrombomodulin resistance in DVT; hypothesis-generating for TACT assay in future risk stratification studies.
We developed a simple assay using rabbit thrombomodulin (TM) based on an activated partial thromboplastin time method, which detected the response to TM in plasma coagulation. We call it thrombomodulin addition clotting time (TACT). The anticoagulant response to TM was calculated by dividing the clotting time with TM by the clotting time with buffer solution. Results were expressed as TACT ratio, which indicates the degree of inhibition of plasma clotting by TM. Using this assay, we measured the TACT ratio in 80 patients with deep-vein thrombosis (DVT) and in 126 controls matched to the patients according to age and sex. A significant difference in the TACT ratio was observed between patients with DVT (mean 1.874) and controls (mean 1.956) (p < 0.001). Twenty- three patients (29%) had TACT ratios below the 10th percentile (1.757) of distribution of control subjects (odds ratio: 3.5; 95% confidence interval (CI): 1.7-7.2). After excluding subjects with a deficiency of protein C, protein S and antithrombin III, we found an odds ratio for DVT of 3.4 (95% CI: 1.6-7.2). These data suggest that natural anticoagulant deficiencies do not influence the TACT ratio, and our case-control study may show that the plasma of patients with DVT has a low response to TM.
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Suehisa et al. (2001) conducted a case-control in Deep venous thrombosis (n=206). Low response to thrombomodulin (TACT ratio below 10th percentile) vs. Normal response to thrombomodulin was evaluated on Deep venous thrombosis (OR 3.5, 95% CI 1.7-7.2). A low response to thrombomodulin, defined as a TACT ratio below the 10th percentile, was significantly associated with deep venous thrombosis (OR 3.5; 95% CI 1.7-7.2).
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