Key result
Factor Xa inhibitors are associated with biphasic thrombin generation curves in acute VTE.
Why the study?
The appearance of thrombin generation curves in platelet rich plasma from patients with acute venous thromboembolism receiving anticoagulant therapy had not been investigated.
What are the characteristics of thrombin generation curves in platelet rich plasma from patients with acute venous thromboembolism receiving anticoagulant therapy?
Observational (n=180)
What are the characteristics of thrombin generation curves in platelet rich plasma from patients with acute venous thromboembolism receiving anticoagulant therapy?
Despite anticoagulant therapy, thrombin generation in the presence of platelets remains active in the majority of acute VTE patients, with unusual biphasic curves strongly associated with Factor Xa inhibitor use.
Biphasic TG curves may mark distinct patient or treatment profiles in acute VTE; this Level 4 observation leaves open their prognostic or therapeutic relevance.
Background. Anticoagulant therapy, the cornerstone treatment in acute venous thromboembolism (VTE), strongly impacts thrombin generation (TG). Until now, the appearance of the TG curve in platelet rich plasma (PRP) from patients with acute VTE has not been investigated. Methods. We analyzed the shape of TG curves measured in PARP of 180 acute VTE patients. Results. Normal shape of TG curves was observed in 110 patients, 50 patients showed no TG and 20 patients showed biphasic TG curve. The linear regression analysis, adjusted for age, sex, VTE clinical phenotypes and therapy showed that the appearance of biphasic curves is significantly associated with female sex, presence of cancer and therapy with Factor Xa inhibitors. Conclusions. This study demonstrated that despite taking anticoagulants, TG in presence of platelets is still present in the majority of acute VTE patients. Appearance of unusual TG curves is strongly related to the intake of anti-Factor Xa inhibitors. The clinical relevance of biphasic TG curve appearance requires further investigation.
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Lagrange et al. (2020) conducted an observational in Acute venous thromboembolism (n=180). Anticoagulant therapy (including Factor Xa inhibitors) was evaluated on Shape of thrombin generation curves. Anticoagulant therapy with Factor Xa inhibitors was significantly associated with the appearance of biphasic thrombin generation curves in patients with acute venous thromboembolism.
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