scholarly journals Hypercoagulability Evaluation in Antiphospholipid Syndrome without Anticoagulation Treatment with Thrombin Generation Assay: A Preliminary Study

2021 ◽  
Vol 10 (12) ◽  
pp. 2728
Author(s):  
Paul Billoir ◽  
Sébastien Miranda ◽  
Herve Levesque ◽  
Ygal Benhamou ◽  
Véronique Le Cam Duchez
Keyword(s):  
Antiphospholipid Syndrome ◽  
Protein C ◽  
Thrombin Generation ◽  
Activated Protein C ◽  
Control Group ◽  
Activated Protein C Resistance ◽  
Thrombin Generation Assay ◽  
Clinical Events ◽  
Biological Criteria ◽  
Preliminary Study

Antiphospholipid syndrome (APS) is associated with thrombotic events (tAPS) and/or obstetrical morbidity (oAPS), with persisting antiphospholipid antibodies (aPL). Despite an update of aPL in 2006, several patients had typical clinical events without the classical biological criteria. The aim of our study was to evaluate the hypercoagulability state with both thrombin generation (TG) profiles and activated protein C resistance (aPCR) in different types of APS. Methods: We retrospectively included 41 patients with Sydney criteria classification (tAPS, oAPS) and no clinical manifestation of APS with persistent aPL (biological APS). A thrombin generation assay was performed with a Fluoroskan Ascent fluorometer in platelet-poor plasma (PPP). Activated protein C resistance was measured as a ratio: ETP+aPC/ETP-aPC × 100. Results: Thrombotic APS and oAPS had an increase of global thrombin generation (ETPcontrol = 808 nM.min (756–853) vs. 1265 nM.min (956–1741) and 1863 nM.min (1434–2080), respectively) (Peakcontrol = 78 nM (74–86) vs. 153 nM (109–215) and 254 nM.min (232–289), respectively). Biological APS had only a lag time increase (Tcontrol = 4.89 ± 1.65 min vs. 13.6 ± 3.9 min). An increased aPCR was observed in tAPS (52.7 ± 16.4%), oAPS (64.1 ± 14.6%) as compared to the control group (27.2 ± 13.8%). Conclusion: Our data suggest an increase of thrombin generation in thrombotic and obstetrical APS and no hypercoagulable states in patients with biological APS. The study of a prospective and a larger controlled cohort could determine the TGA useful for APS monitoring and could confirm an aPCR evaluation in PPP.

Prevalence of Factor V Leiden Is Not Increased in Women with Recurrent Miscarriage

1997 ◽  
Vol 3 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Jack Metz ◽  
Michael Kloss ◽  
Cindy J. O'Malley ◽  
Steven P. Rockman ◽  
Lidia DeRosa ◽  
...  
Keyword(s):  
Protein C ◽  
Recurrent Miscarriage ◽  
Activated Protein C ◽  
Factor V Leiden ◽  
Subsequent Pregnancy ◽  
Control Group ◽  
Therapeutic Trial ◽  
Factor V ◽  
Activated Protein C Resistance ◽  
Antithrombotic Prophylaxis

The purpose of this study was to determine if there is an increased prevalence of the thrombophilic genetic mutant factor V Leiden in patients with recurrent miscarriage. Functional assays were conducted for activated protein C resistance and genetic detection of factor V Leiden in 100 women with recurrent miscarriage compared with a control group. The prevalence of factor V Leiden in patients was 6/100 (6%) compared with 3/85 (3.5%) in controls. The difference was not statistically significant. Antithrombotic prophylaxis with heparin and/ or aspirin in a subsequent pregnancy in five of the six patients with factor V Leiden was associated with maintenance of pregnancy and delivery of a live, healthy, full-term infant in four. We have been unable to demonstrate a statistically significant increased prevalence of factor V Leiden in women with recurrent miscarriage. If antithrombotic prophylaxis in pregnancy can be shown by controlled therapeutic trial to prevent miscarriage in these patients, identification of this subgroup would be important. Key Words: Recurrent miscarriage—Factor V Leiden—Activated protein C resistance.

An activated protein C-dependent thrombin generation assay predicts chemotherapy-associated venous thromboembolism in cancer patients

2011 ◽  
Vol 105 (05) ◽  
pp. 931-932 ◽  
Author(s):  
Francesca Martini ◽  
Ilaria Portarena ◽  
Italia Grenga ◽  
Silvia Riondino ◽  
Francesca La Farina ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Protein C ◽  
Thrombin Generation ◽  
Activated Protein C ◽  
Thrombin Generation Assay

C0136: A Modification of Calibrated Automated Thrombin Generation Assay to Explore New Cofactors of Activated Protein C in Plasma

2014 ◽  
Vol 133 ◽  
pp. S71
Author(s):  
L. Martos ◽  
P. Medina ◽  
H. Deguchi ◽  
E. Bonet ◽  
L.A. Ramón ◽  
...  
Keyword(s):  
Protein C ◽  
Thrombin Generation ◽  
Activated Protein C ◽  
Thrombin Generation Assay

scholarly journals A Retrospective Cross-sectional Study on Activated Protein C Resistance (Factor V Leiden): an Independent, Gender-dependent Risk Factor for Venous Thromboembolism

2021 ◽  
Author(s):  
Vahideh Takhviji ◽  
Kazem Zibara ◽  
Asma Maleki ◽  
Ebrahim Azizi ◽  
Sanaz Hommayoun ◽  
...  
Keyword(s):  
Risk Factor ◽  
Venous Thromboembolism ◽  
Protein C ◽  
Activated Protein C ◽  
Factor V Leiden ◽  
Control Group ◽  
Factor V ◽  
Activated Protein C Resistance ◽  
Cross Sectional ◽  
Factor V Leiden Mutation

Abstract Background: Activated protein C resistance (APCR) due to factor V R506Q (Leiden) mutation is a major risk factor in patients with venous thromboembolism. The present study investigated the symptoms patterns and the risk for venous thromboembolism regarding multiple clinical, laboratory, and demographic properties in APCR patients.Material and Methods: A retrospective cross-sectional analysis was conducted on a total of 288 APCR patients with age interval ranging between 1 to 80 years. In addition, 288 control samples, reported healthy after confirmatory tests, were also randomly selected. Demographic information, clinical manifestations, family and treatment history were recorded, and specific tests applied.Results: APCR was found to be 2.3 times significantly more likely in men (OR: 2.1, p < 0.05) than women. The risk of DVT and PE in APCR patients was 4.5 and 3.2 times more than the normal group, respectively (p < 0.05). However, APCR could not be an independent risk factor for arterial thrombosis and pregnancy complications. Moreover, patients were evaluated for thrombophilia panel tests and showed significantly lower protein C and S than the control group and patients without DVT (p<0.0001).Conclusion: Factor V Leiden mutation and APCR abnormality are noticeable independent risk factors for venous thromboembolism. Screening strategies for factor V Leiden mutation in patients undergoing surgery, oral contraceptive medication, and pregnancy cannot be recommended, but a phenotypic test for activated protein C resistance should be endorsed in patients with venous thromboembolism.

scholarly journals Comparison of Acquired Activated Protein C Resistance, Using the CAT and ST-Genesia® Analysers and Three Thrombin Generation Methods, in APS and SLE Patients

2021 ◽  
Vol 11 (1) ◽  
pp. 69
Author(s):  
Maria Efthymiou ◽  
Philip J. Lane ◽  
David Isenberg ◽  
Hannah Cohen ◽  
Ian J. Mackie
Keyword(s):  
Lupus Erythematosus ◽  
Protein C ◽  
Thrombin Generation ◽  
Activated Protein C ◽  
Kappa Coefficient ◽  
Antiphospholipid Antibody ◽  
Data Handling ◽  
Activated Protein C Resistance ◽  
Systemic Lupus ◽  
Pregnancy Morbidity

Background: Acquired activated protein C resistance (APCr) has been identified in antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). Objective: To assess agreement between the ST-Genesia® and CAT analysers in identifying APCr prevalence in APS/SLE patients, using three thrombin generation (TG) methods. Methods: APCr was assessed with the ST-Genesia using STG-ThromboScreen and with the CAT using recombinant human activated protein C and Protac® in 105 APS, 53 SLE patients and 36 thrombotic controls. Agreement was expressed in % and by Cohen's kappa coefficient. Results: APCr values were consistently lower with the ST-Genesia® compared to the CAT, using either method, in both APS and SLE patients. Agreement between the two analysers in identifying APS and SLE patients with APCr was poor (≤65.9%, ≤0.20) or fair (≤68.5%, ≥0.29), regardless of TG method, respectively; no agreement was observed in thrombotic controls. APCr with both the ST Genesia and the CAT using Protac®, but not the CAT using rhAPC, was significantly greater in triple antiphospholipid antibody (aPL) APS patients compared to double/single aPL patients (p < 0.04) and in thrombotic SLE patients compared to non-thrombotic SLE patients (p < 0.05). Notably, the ST-Genesia®, unlike the CAT, with either method, identified significantly greater APCr in pregnancy morbidity (median, confidence intervals; 36.9%, 21.9–49.0%) compared to thrombotic (45.7%, 39.6–55.5%) APS patients (p = 0.03). Conclusion: Despite the broadly similar methodology used by CAT and ST-Genesia®, agreement in APCr was poor/fair, with results not being interchangeable. This may reflect differences in the TG method, use of different reagents, and analyser data handling.

scholarly journals Activated protein C resistance determined with a thrombin generation-based test predicts for venous thrombosis in men and women

2003 ◽  
Vol 122 (3) ◽  
pp. 465-470 ◽  
Author(s):  
Guido Tans ◽  
Astrid Van Hylckama Vlieg ◽  
M. Christella L. G. D. Thomassen ◽  
Joyce Curvers ◽  
Rogier M. Bertina ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Protein C ◽  
Thrombin Generation ◽  
Activated Protein C ◽  
Activated Protein C Resistance ◽  
Men And Women
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