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PLoS One. 2018 Jun 28;13(6):e0199900. doi: 10.1371/journal.pone.0199900. eCollection 2018.

Thrombodynamics-A new global hemostasis assay for heparin monitoring in patients under the anticoagulant treatment.

Author information

1
Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
2
Center for Theoretical Problems of Physicochemical Pharmacology, Moscow, Russia.
3
Russian Laboratory Federation, Moscow, Russia.
4
City Clinical Hospital No. 15, Moscow, Russia.
5
Altay Regional Clinical Hospital, Barnaul, Russia.
6
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
7
National Research Center for Hematology, Moscow, Russia.
8
City Clinical Hospital No. 24, Moscow, Russia.
9
National Research Center for Hematology, Altay Department, Barnaul, Russia.
10
Moscow State University, Moscow, Russia.
11
Moscow Institute of Physics and Technology, Dolgoprudny, Russia.

Abstract

BACKGROUND:

Heparin therapy and prophylaxis may be accompanied by bleeding and thrombotic complications due to individual responses to treatment. Dosage control based on standard laboratory assays poorly reflects the effect of the therapy. The aim of our work was to compare the heparin sensitivity of new thrombodynamics (TD) assay with sensitivity of other standard and global coagulation tests available to date.

STUDY POPULATION AND METHODS:

A total of 296 patients with high risk of venous thromboembolism (deep vein thrombosis (DVT), early postoperative period, hemoblastosis) were enrolled in the study. We used a case-crossover design to evaluate the sensitivity of new thrombodynamics assay (TD) to the hemostatic state before and after unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) therapy/prophylaxis and to compare it with the activated partial thromboplastin time (APTT), anti-Xa activity test, thrombin generation test (TGT) and thromboelastography (TEG). A receiver operating characteristic (ROC) curve analysis was used to evaluate changes before and after heparin prophylaxis and therapy. Blood was sampled before heparin injection, at the time of maximal blood heparin concentration and before the next injection.

RESULTS:

Hypercoagulation before the start of heparin treatment was detected by TD, TGT and TEG but not by APTT. The area under the ROC curve (AUC) was maximal for TD and anti-Xa, intermediate for TGT and TEG and minimal for APTT.

CONCLUSIONS:

These results indicate that TD has a high sensitivity to the effects of UFH and LMWH after both prophylactic and therapeutic regimes and may be used for heparin monitoring.

PMID:
29953528
PMCID:
PMC6023127
DOI:
10.1371/journal.pone.0199900
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

We disclose a conflict of interest for Prof. Fazoil Ataullakhanov, who is a co-founder of HemaCore LLC, which holds several patents and patent applications that are related to the diagnostic use of spatial clot growth and which has developed the assay under the trade name of Thrombodynamics® (Ataullakhanov FI, international patent applications PCT/CH2007/000543 filing date 02.11.2007 and РСТ/RU2012/000570 filing date 16.07.2012). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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