Intraindividual variability over time of thrombin generation in patients with cirrhosis - INRAE - Institut national de recherche pour l’agriculture, l’alimentation et l’environnement Access content directly
Journal Articles Journal of Thrombosis and Haemostasis Year : 2023

Intraindividual variability over time of thrombin generation in patients with cirrhosis

Abstract

Background: Patients with cirrhosis are at high risk of thrombotic events, including portal vein thrombosis and venous thromboembolism. In such patients, hypercoagula-bility is not detected by conventional coagulation tests, but only by the thrombin generation assay (TGA) that integrates the role of pro-and anticoagulant factors. However, TGA use to predict clinical events depends on thrombin generation vari-ability over time.Objectives: The aim of this study was to compare TGA intraindividual variability over time in patients with cirrhosis and in healthy controls. Methods: Blood samples were prospectively collected from 34 healthy controls and 52 patients with cirrhosis at week 0 (inclusion), 6, and 12. TGA was performed with the calibrated automated thrombogram method, tissue factor (5 pM), phospholipids, and with and without thrombomodulin (4 nM) or activated protein C (1 nM). Results: When TGA was performed with thrombomodulin, endogenous thrombin po-tential in patients with cirrhosis was higher compared with controls and increased with cirrhosis severity. Stability over time of all thrombin generation parameters was excellent in healthy controls, good in Child-Turcotte-Pugh (CTP)-A patients, and poor in CTP-B/C patients (severe cirrhosis). In CTP-B/C patients, the phenotype was more variable because one-third of patients switched to normal or hypercoagulability during the 3-month follow-up.Conclusion: A study with longer monitoring is needed to correlate the hypercoagulable phenotype of patients with cirrhosis with the occurrence of thrombotic events.

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Hematology
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Dates and versions

hal-04353454 , version 1 (19-12-2023)

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Thomas Sinegre, Cédric Duron, Thomas Lecompte, Géraldine Lamblin, Laurie Talon, et al.. Intraindividual variability over time of thrombin generation in patients with cirrhosis. Journal of Thrombosis and Haemostasis, 2023, 21 (6), pp.1441-1452. ⟨10.1016/j.jtha.2023.02.002⟩. ⟨hal-04353454⟩
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