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Validation of a modified thromboelastometry approach to detect changes in fibrinolytic activity

Overview of attention for article published in Thrombosis Journal, January 2016
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Title
Validation of a modified thromboelastometry approach to detect changes in fibrinolytic activity
Published in
Thrombosis Journal, January 2016
DOI 10.1186/s12959-016-0076-2
Pubmed ID
Authors

Gerhardus J. A. J. M. Kuiper, Marie-Claire F. Kleinegris, René van Oerle, Henri M. H. Spronk, Marcus D. Lancé, Hugo ten Cate, Yvonne M. C. Henskens

Abstract

Thus far, validated whole blood assays used in in vitro fibrinolysis experiments using thromboelastometry (ROTEM) are lacking or have yet to be tested in humans. The objective was first, to establish a standardized modified ROTEM approach to detect both hypo- and hyperfibrinolysis. And second, to perform a technical and clinical validation of the assay. Blood was used of healthy volunteers, patients with sepsis, patients after cardiothoracic surgery, pregnant women, and cirrhotic liver disease patients. A whole blood tissue factor (TF) activated ROTEM assay with and without the addition of recombinant tissue plasminogen activator (rTPA) was developed. Plasma fibrinolysis determinants were measured in all volunteers and patients. Thirty five pM TF and additions of 125 and 175 ng/ml rTPA resulted in full lysis within 60 min in healthy volunteers. Coefficients of variation were below 10 % without and below 20 % with rTPA addition. In sepsis the hypofibrinolytic ROTEM profiles with 175 ng/ml rTPA were in line with the plasma determinants (high PAI-1, high fibrinogen, low tPA activity, and high d-dimers). After cardiothoracic surgery, reduced fibrinogen and platelet levels accounted for the reduced maximum clot firmness. The hypofibrinolytic profile is attributed to tranexamic acid use and elevated PAI-1 levels. The lowest rTPA concentration in cirrhosis resulted in hyperfibrinolysis in only few of the patients. In pregnancy normal profiles were found. Our high rTPA concentration demonstrates hypofibrinolytic profiles adequately in sepsis and after cardiothoracic surgery. Our low rTPA concentration of 125 ng/ml seems too high for demonstrating hyperfibrinolysis in cirrhotic liver disease. We were able to present a validated whole blood ROTEM approach to fibrinolysis testing using added rTPA, which can be of added value next to classical plasma based fibrinolysis assays.

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Mendeley readers

The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Czechia 1 2%
Belgium 1 2%
Unknown 64 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 20%
Other 12 18%
Student > Ph. D. Student 7 11%
Student > Master 7 11%
Student > Postgraduate 6 9%
Other 13 20%
Unknown 8 12%
Readers by discipline Count As %
Medicine and Dentistry 34 52%
Agricultural and Biological Sciences 4 6%
Engineering 3 5%
Nursing and Health Professions 2 3%
Veterinary Science and Veterinary Medicine 2 3%
Other 9 14%
Unknown 12 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 January 2016.
All research outputs
#13,799,572
of 15,640,884 outputs
Outputs from Thrombosis Journal
#169
of 184 outputs
Outputs of similar age
#278,431
of 340,997 outputs
Outputs of similar age from Thrombosis Journal
#1
of 1 outputs
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