Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study

Abstract Background Cerebral venous sinus thrombosis (CVST) is a relatively rare, but potentially lethal condition. In approximately 15% of the patients, the cause of CVST remains unclear. Conventional clotting tests such as prothrombin time and activated partial thromboplastin time are not sensitiv...

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Autores principales:	Myrthe M. van der Bruggen, Bram Kremers, Rene van Oerle, Robert J. van Oostenbrugge, Hugo ten Cate
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/55ae70af15cf4733804f789e7cd5d2dc
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spelling	oai:doaj.org-article:55ae70af15cf4733804f789e7cd5d2dc2021-11-08T10:58:46ZPotential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study10.1186/s12959-021-00335-11477-9560https://doaj.org/article/55ae70af15cf4733804f789e7cd5d2dc2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12959-021-00335-1https://doaj.org/toc/1477-9560Abstract Background Cerebral venous sinus thrombosis (CVST) is a relatively rare, but potentially lethal condition. In approximately 15% of the patients, the cause of CVST remains unclear. Conventional clotting tests such as prothrombin time and activated partial thromboplastin time are not sensitive enough to detect prothrombotic conditions nor mild haemostatic abnormalities. The calibrated automated thrombogram (CAT) is a physiological function test that might be able to detect minor aberrations in haemostasis. Therefore, we aimed to detect the presence of a prothrombotic state in patients who endured idiopathic CVST with the CAT assay. Methods Five adult patients with an idiopathic, radiologically proven CVST that had been admitted during the past 3 years were included in this study. The control group consisted of five age/gender matched healthy volunteers. Exclusion criteria were known haematological disorders, malignancy (current/past) or hormonal and anticoagulant therapy recipients. We obtained venous blood samples from all participants following cessation of anticoagulation. Using the CAT assay, we determined lag time, normalized endogenous thrombin potential (ETP), ETP reduction and normalized peak height. In addition, prothrombin concentrations were determined. Results We found no significant differences in lag time (4.7 min [4.5–4.9] vs 5.3 min [3.7–5.7], p = 0.691), normalized ETP (142% [124–148] vs 124% [88–138], p = 0.222), ETP reduction (29% [26–35] vs 28% [24–58], p > 0.999), and normalized peak height (155% [153–175] vs 137 [94–154], p = 0.056) between patients and their age/gender matched controls. In addition, prothrombin concentrations did not significantly differ between patients and controls (120% [105–132] vs 127% [87–139], p > 0.999). Conclusion Reasons for absent overt hypercoagulability within this study population may be the small patient sample, long time since the event (e.g. 3 years) and avoidance of acquired risk factors like oral contraception. Given the fact that CVST is a serious condition with a more than negligible risk of venous thrombosis event recurrence, exclusion of clinically relevant hypercoagulability remains a challenging topic to further study at the acute and later time points, particularly in patients with idiopathic CVST.Myrthe M. van der BruggenBram KremersRene van OerleRobert J. van OostenbruggeHugo ten CateBMCarticleDiseases of the blood and blood-forming organsRC633-647.5ENThrombosis Journal, Vol 19, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Diseases of the blood and blood-forming organs RC633-647.5 Myrthe M. van der Bruggen Bram Kremers Rene van Oerle Robert J. van Oostenbrugge Hugo ten Cate Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
description	Abstract Background Cerebral venous sinus thrombosis (CVST) is a relatively rare, but potentially lethal condition. In approximately 15% of the patients, the cause of CVST remains unclear. Conventional clotting tests such as prothrombin time and activated partial thromboplastin time are not sensitive enough to detect prothrombotic conditions nor mild haemostatic abnormalities. The calibrated automated thrombogram (CAT) is a physiological function test that might be able to detect minor aberrations in haemostasis. Therefore, we aimed to detect the presence of a prothrombotic state in patients who endured idiopathic CVST with the CAT assay. Methods Five adult patients with an idiopathic, radiologically proven CVST that had been admitted during the past 3 years were included in this study. The control group consisted of five age/gender matched healthy volunteers. Exclusion criteria were known haematological disorders, malignancy (current/past) or hormonal and anticoagulant therapy recipients. We obtained venous blood samples from all participants following cessation of anticoagulation. Using the CAT assay, we determined lag time, normalized endogenous thrombin potential (ETP), ETP reduction and normalized peak height. In addition, prothrombin concentrations were determined. Results We found no significant differences in lag time (4.7 min [4.5–4.9] vs 5.3 min [3.7–5.7], p = 0.691), normalized ETP (142% [124–148] vs 124% [88–138], p = 0.222), ETP reduction (29% [26–35] vs 28% [24–58], p > 0.999), and normalized peak height (155% [153–175] vs 137 [94–154], p = 0.056) between patients and their age/gender matched controls. In addition, prothrombin concentrations did not significantly differ between patients and controls (120% [105–132] vs 127% [87–139], p > 0.999). Conclusion Reasons for absent overt hypercoagulability within this study population may be the small patient sample, long time since the event (e.g. 3 years) and avoidance of acquired risk factors like oral contraception. Given the fact that CVST is a serious condition with a more than negligible risk of venous thrombosis event recurrence, exclusion of clinically relevant hypercoagulability remains a challenging topic to further study at the acute and later time points, particularly in patients with idiopathic CVST.
format	article
author	Myrthe M. van der Bruggen Bram Kremers Rene van Oerle Robert J. van Oostenbrugge Hugo ten Cate
author_facet	Myrthe M. van der Bruggen Bram Kremers Rene van Oerle Robert J. van Oostenbrugge Hugo ten Cate
author_sort	Myrthe M. van der Bruggen
title	Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
title_short	Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
title_full	Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
title_fullStr	Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
title_full_unstemmed	Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
title_sort	potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/55ae70af15cf4733804f789e7cd5d2dc
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Potential value of the calibrated automated thrombogram in patients after a cerebral venous sinus thrombosis; an exploratory study

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