Thromb Haemost 2007; 98(04): 871-882
DOI: 10.1160/TH06-07-0370
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

A global assay of haemostasis which uses recombinant tissue factor and tissue-type plasminogen activator to measure the rate of fibrin formation and fibrin degradation in plasma

Shu He
1   Karolinska Institutet: Department of Clinical Science, Danderyds Hospital, Royal Institute of Technology, Stockholm, Sweden
4   Department of Molecular Medicine & Surgery, Coagulation Research, Royal Institute of Technology, Stockholm, Sweden
,
Kun Zhu
6   Department of Numerical Analysis and Computer Science, Royal Institute of Technology; Stockholm, Sweden
,
Mika Skeppholm
2   Karolinska Institutet: Division of Cardiology and Danderyds Hospital, Royal Institute of Technology, Stockholm, Sweden
,
Jenny Vedin
5   Department of Cardiothoracic Surgery & Anaesthesia and Royal Institute of Technology, Stockholm, Sweden
,
Jan Svensson
1   Karolinska Institutet: Department of Clinical Science, Danderyds Hospital, Royal Institute of Technology, Stockholm, Sweden
3   Karolinska Institutet: Division of Clinical Chemistry, Danderyds Hospital, Royal Institute of Technology, Stockholm, Sweden
,
Nils Egberg
4   Department of Molecular Medicine & Surgery, Coagulation Research, Royal Institute of Technology, Stockholm, Sweden
,
Margareta Blombäck
1   Karolinska Institutet: Department of Clinical Science, Danderyds Hospital, Royal Institute of Technology, Stockholm, Sweden
4   Department of Molecular Medicine & Surgery, Coagulation Research, Royal Institute of Technology, Stockholm, Sweden
› Author Affiliations
Financial support: This study was supported by funds from Karolinska Institutet, the Swedish Society of Medicine and the Magnus Bergvall Foundation.
Further Information

Publication History

Received 06 July 2006

Accepted after resubmission 20 July 2007

Publication Date:
01 December 2017 (online)

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Summary

The global assay of Overall Haemostasis Potential we previously described has been refined. The coagulation cascade in plateletpoor plasma is triggered by adding a minimal dose of recombinant tissue factor together with purified phospholipids and calcium; fibrinolysis is initiated by adding recombinant tissue type-plasminogen activator in a concentration similar to what can be obtained during thrombolysis. Numerical differentials of optical densities reflecting rates of fibrin formation and degradation are calculated by a new software, and the Coagulation Profile (Cp) and the Fibrinolysis Profile (Fp) are determined. The combined effect of these counteractive systems is expressed as a ratio of Cp to Fp, called the Overall Haemostasis Index. Commercially available coagulant-deficient patient plasma samples and plasma with various amounts of added PAI-1 are examined; changes of fibrin turbidity demonstrate that this assay can determine Cp and Fp in a physiologically relevant way. Increased Cp and decreased Fp in prothrombotic patients, as well as expected effects of heparin or a thrombin inhibitor on Cp and Fp, suggest that our method can detect hypercoagulability and assist in monitoring antithrombotic treatment. Ongoing studies will show whether this simple assay can be of value in clinical routine.