Abstract
Clot waveform analysis (CWA) is a recently developed global coagulation assessment,
based on the continuous observation of changes in light transmittance, absorbance,
or light scattering that occurs as fibrin formed in a plasma sample during routine
clotting tests such as activated partial thromboplastin time (aPTT) and prothrombin
time (PT). CWA can utilize qualitative waveform patterns as well as sensitive quantitative
parameters and can be used as a simple method to assess global hemostasis, and can
be applied to various challenging clinical situations. Although not all coagulation
analyzers currently in use are able to provide CWA, the number of analyzers available
to do so is increasing, as the usefulness of this process has become more widely recognized.
CWA can be based on the coagulation mechanism of aPTT, an intrinsic trigger, and this
has been reported in many studies, including diagnosis and treatment of patients with
hemophilia, disseminated intravascular coagulation, and monitoring of anticoagulants
and thrombosis. CWA using trace amounts of tissue factors also has the potential to
expand the applications of this technology. Recently, there have been reports of the
combined evaluation of fibrinolytic dynamics. Among the existing global coagulation
assays, CWA may prove to be the easiest to standardize in clinical practice. However,
more extensive testing using standardized methods in various clinical settings is
needed to determine the true role of CWA in the evaluation of hemostasis and thrombosis
in the future.
Keywords
activated partial thromboplastin time - clot waveform analysis - coagulation - fibrinolysis
- hemophilia
