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Thromb Haemost 1997; 77(04): 629-636
DOI: 10.1055/s-0038-1656024
Clinical Studies
Schattauer GmbH Stuttgart

The Routine Determination of the Endogenous Thrombin Potential, First Results in Different Forms of Hyper- and Hypocoagulability

Simone Wielders
1   The Department of Biochemistry, Medical Faculty and Cardiovascular Research Institute, Maastricht University, The Netherlands
,
Manjari Mukherjee
2   The Thrombosis Research Institute, London, England
,
Jan Michiels
3   The Clara Ziekenhuis Rotterdam, The Netherlands
,
Dirk T S Rijkers
1   The Department of Biochemistry, Medical Faculty and Cardiovascular Research Institute, Maastricht University, The Netherlands
,
Jean-Pierre Cambus
4   The Hôpital de Ranguell, Toulouse, France
,
Richard W C Knebel
5   The Hôpital Broussais, Laboratoire d’Hémostase, Paris, France
,
Vijay Kakkar
2   The Thrombosis Research Institute, London, England
,
H Coenraad Hemker
1   The Department of Biochemistry, Medical Faculty and Cardiovascular Research Institute, Maastricht University, The Netherlands
2   The Thrombosis Research Institute, London, England
,
Suzette Béguin
1   The Department of Biochemistry, Medical Faculty and Cardiovascular Research Institute, Maastricht University, The Netherlands
2   The Thrombosis Research Institute, London, England
› Author Affiliations
Further Information

Publication History

Received 30 August 1996

Accepted after resubmission 03 December 1996

Publication Date:
11 July 2018 (online)

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Summary

The area under the thrombin generation curve (the endogenous thrombin potential; ETP) has been proposed as a parameter for plasma-based hypercoagulability and to monitor anticoagulant treatment. We present an ETP assay for the routine laboratory using a centrifugal analyser. Throughput is 30 samples/h, within and between run imprecision is 4-5.6%. Suitable substrates were developed for the ranges of 10-500% and 2-100% of normal.

Independent of tissue factor concentration (if >4 pM), the normal value of the extrinsic ETP is 384.8 ±51.7 nM.min. The intrinsic ETP, triggered by ellagic acid, is 414 ± 41 nM.min.

The ETP is decreased to 15 and 35% of normal by oral anticoagulation (INR 2.5-4.0) and by heparin administration (APTT 1.5-2.5 X control).

The ETP is increased in untreated subjects with congenital antithrombin deficiency and in women using oral contraceptives. In deep vein thrombosis (phlebographically confirmed), it is increased by 29.4% (extrinsic) and 53% (intrinsic). In (angiographically assessed) coronary artery disease the increase is by 10% and 17% respectively.

 

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