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Talanta. 2018 Apr 1;180:282-291. doi: 10.1016/j.talanta.2017.12.055. Epub 2017 Dec 19.

Thrombodynamics, a new global coagulation test: Measurement of heparin efficiency.

Author information

1
Laboratory of Biophysics, Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Samory Mashela str., 1, GSP-7, Moscow 117997, Russia; Laboratory of Biophysics of the Cell, Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str., 4, Moscow 119334, Russia. Electronic address: sinaurid@list.ru.
2
Laboratory of Translational Medicine, Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Samory Mashela str., 1, GSP-7, Moscow 117997, Russia. Electronic address: tagaty@yandex.ru.
3
Laboratory of Physical Biochemistry, National Research Center for Hematology, Novyi Zykovskii pr., 4, Moscow 125167, Russia. Electronic address: taran@list.ru.
4
Laboratory of Translational Medicine, Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Samory Mashela str., 1, GSP-7, Moscow 117997, Russia. Electronic address: ovsepyanru@mail.ru.
5
Laboratory of Biophysics of the Cell, Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str., 4, Moscow 119334, Russia. Electronic address: cntgfy@inbox.ru.
6
Scientific Department, Hematological Corporation HemaCore LLC, Nauchnyi pr., 20, build. 2, Moscow 117246, Russia. Electronic address: natalia.korotina@gmail.com.
7
Scientific Department, Hematological Corporation HemaCore LLC, Nauchnyi pr., 20, build. 2, Moscow 117246, Russia. Electronic address: serebsiysky@mail.ru.
8
Department of Low Invasive Surgery, Treatment and Rehabilitation Center, Ivankovskoe shosse, 3, Moscow 125367, Russia. Electronic address: maxmaxovich@mail.ru.
9
Department of Low Invasive Surgery, Treatment and Rehabilitation Center, Ivankovskoe shosse, 3, Moscow 125367, Russia. Electronic address: a-sokolov@list.ru.
10
Laboratory of Biophysics, Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Samory Mashela str., 1, GSP-7, Moscow 117997, Russia; Laboratory of Biophysics of the Cell, Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Kosygina str., 4, Moscow 119334, Russia; Scientific Department, Hematological Corporation HemaCore LLC, Nauchnyi pr., 20, build. 2, Moscow 117246, Russia; Department of Physics, Moscow State University, Leninskie Gory, 1, build. 2, GSP-1, Moscow 119991, Russia; Department of Biological and Medical Physics, Moscow Institute of Physics and Technology, Institutskii per., 9, Dolgoprudny, Moscow Region 141701, Russia. Electronic address: ataullakhanov.fazly@gmail.com.

Abstract

The actual coagulation status may be reliably measured using only highly sensitive global functional tests; however, they are not numerous and all of them have disadvantages. Thrombodynamics (TD), a novel global coagulation test, is sensitive to hypo- and hypercoagulable states. The main properties of this test were investigated, and its capabilities for hemostasis analysis were verified through pharmacodynamic monitoring of the most widely used anticoagulants, heparins. The anticoagulant effects in the plasma of donors (n = 20) and patients after hip replacement (n = 20) spiked with unfractionated heparin or enoxaparin were measured in vitro to eliminate the influence of pharmacokinetic factors. Sensitivity for heparins was compared for activated partial thromboplastin time, thrombin generation tests and TD. TD was shown to reliably characterize the pharmacodynamics of any heparin in the entire range of its prophylactic and therapeutic concentrations. Inter-individual variability for the anticoagulant action of heparins was also calculated using the TD data. This variability did not differ between the investigated groups and did not exceed 12% and 20% for the stationary clot growth rate in the presence of unfractionated heparin and enoxaparin, respectively. That finding was in accordance with the values determined earlier using the thrombin generation test. The study results showed that TD has advantages over the other global methods of coagulation analysis. These advantages are good standardization, high reproducibility, independence of the parameter values from patient age and gender, and a narrower parameter distribution in a normal population. These results indicate that TD is a promising universal assessment method that improves the quality of hemostasis analysis because it more reliably detects deviations from the parameters' reference values.

KEYWORDS:

Blood coagulation; Heparin; Inter-individual variability; Laboratory monitoring; Thrombin generation test; Thrombodynamics test

PMID:
29332812
DOI:
10.1016/j.talanta.2017.12.055
[Indexed for MEDLINE]
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