Calibrated automated thrombogram

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The calibrated automated thrombogram (CAT or CT) is a thrombin generation assay (TGA) and global coagulation assay (GCA) which can be used as a coagulation test to assess thrombotic risk. [1] [2] It is the most widely used TGA. [3] The CAT is a semi-automated test performed in a 96-well plate and requires specialized technologists to be performed. [3] As a result, it has seen low implementation in routine laboratories and has been more limited to research settings. [3] [4] Lack of standardization with the CAT has also led to difficulties in study-to-study comparisons in research. [3] [5] However, efforts have recently been made towards standardization of the assay. [5] [6] [7] [8] An example of a specific commercial CAT is the Thrombinoscope by Thrombinoscope BV (now owned by Diagnostica Stago). [9]

The CAT can be used to measure thrombogram parameters such as the endogenous thrombin potential (ETP) [2] [10] and to assess activated protein C resistance (APCR). [5] The CAT ETP-based APC resistance test is especially sensitive to estrogen-induced procoagulation, such as with combined oral contraceptives. [2] [5] [11]

In 2018, a commercial fully automated TGA system and alternative to the CAT called the ST Genesia debuted. [3] It has been said that this system should allow for more widespread adoption of TGAs in clinical laboratories. [3] [12] The ST Genesia system also shows improved reproducibility compared to the CAT. [3]

References

  1. ↑ Hemker HC, Giesen P, AlDieri R, Regnault V, de Smed E, Wagenvoord R, Lecompte T, Béguin S (2002). "The calibrated automated thrombogram (CAT): a universal routine test for hyper- and hypocoagulability". Pathophysiol Haemost Thromb. 32 (5–6): 249–53. doi:10.1159/000073575. PMID   13679651. S2CID   8378673.
  2. 1 2 3 Lim HY, Donnan G, Nandurkar H, Ho P (January 2022). "Global coagulation assays in hypercoagulable states". J Thromb Thrombolysis. 54 (1): 132–144. doi:10.1007/s11239-021-02621-1. PMID   34997471. S2CID   245804095.
  3. 1 2 3 4 5 6 7 Reda S, Morimont L, Douxfils J, Rühl H (August 2020). "Can We Measure the Individual Prothrombotic or Prohemorrhagic Tendency by Global Coagulation Tests?". Hamostaseologie. 40 (3): 364–378. doi: 10.1055/a-1153-5824 . PMID   32726831. S2CID   220878363.
  4. ↑ Lim HY, Leemaqz SY, Torkamani N, Grossmann M, Zajac JD, Nandurkar H, Ho P, Cheung AS (July 2020). "Global Coagulation Assays in Transgender Women on Oral and Transdermal Estradiol Therapy". J Clin Endocrinol Metab. 105 (7): e2369 –e2377. doi: 10.1210/clinem/dgaa262 . PMID   32413907. S2CID   218659931.
  5. 1 2 3 4 Morimont L, Haguet H, Dogné JM, Gaspard U, Douxfils J (2021). "Combined Oral Contraceptives and Venous Thromboembolism: Review and Perspective to Mitigate the Risk". Front Endocrinol (Lausanne). 12: 769187. doi: 10.3389/fendo.2021.769187 . PMC   8697849 . PMID   34956081.
  6. ↑ Douxfils J, Morimont L, Delvigne AS, Devel P, Masereel B, Haguet H, Bouvy C, Dogné JM (January 2020). "Validation and standardization of the ETP-based activated protein C resistance test for the clinical investigation of steroid contraceptives in women: an unmet clinical and regulatory need". Clin Chem Lab Med. 58 (2): 294–305. doi:10.1515/cclm-2019-0471. PMID   31444961. S2CID   201644826.
  7. ↑ Morimont L, Bouvy C, Delvigne AS, Dogné JM, Douxfils J (April 2020). "Proof of concept of a new scale for the harmonization and the standardization of the ETP-based APC resistance". J Thromb Haemost. 18 (4): 895–904. doi: 10.1111/jth.14745 . PMID   31984653. S2CID   210922482.
  8. ↑ Morimont L, Didembourg M, Haguet H, Modaffari É, Tillier M, Bouvy C, Lebreton A, Dogné JM, Douxfils J (October 2021). "Interlaboratory variability of activated protein C resistance using the ETP-based APC resistance assay". Res Pract Thromb Haemost. 5 (7) e12612. doi:10.1002/rth2.12612. PMC   8563922 . PMID   34761157.
  9. ↑ Kintigh J, Monagle P, Ignjatovic V (January 2018). "A review of commercially available thrombin generation assays". Res Pract Thromb Haemost. 2 (1): 42–48. doi:10.1002/rth2.12048. PMC   6055498 . PMID   30046705.
  10. ↑ Duarte RC, Ferreira CN, Rios DR, Reis HJ, Carvalho MD (2017). "Thrombin generation assays for global evaluation of the hemostatic system: perspectives and limitations". Rev Bras Hematol Hemoter. 39 (3): 259–265. doi:10.1016/j.bjhh.2017.03.009. PMC   5568585 . PMID   28830606.
  11. ↑ Tchaikovski SN, Rosing J (July 2010). "Mechanisms of estrogen-induced venous thromboembolism". Thromb Res. 126 (1): 5–11. doi:10.1016/j.thromres.2010.01.045. PMID   20163835.
  12. ↑ Favaloro EJ, Lippi G (April 2019). "Recent Advances in Mainstream Hemostasis Diagnostics and Coagulation Testing". Semin Thromb Hemost. 45 (3): 228–246. doi:10.1055/s-0038-1676579. PMID   30912101. S2CID   85517668.


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