Thrombin is at the heart of haemostasis, the balance between thrombosis and bleeding. Being able to measure thrombin generation accurately can have a fundamental impact on a patient’s treatment plan and survival, as Laurence Loï explains.
Understanding the importance of thrombin and the limitations of current assays and analysers was the theme of Stago’s New Technology Showcase at the recent IBMS Congress in Birmingham. The audience also had the opportunity to preview the ST Genesia, the UK’s first fully automated thrombin generation analyser, available later in 2016. The new system has been designed specifically to bring continuous monitoring of thrombin generation (TG) into the heart of a laboratory’s routine coagulation analysis.
Stago has gained a worldwide reputation for its diagnostic innovation in coagulation and haemostasis since the company was established almost 70 years ago. However, its prime focus has never been simply to develop and design instruments and different test methods, but to further the understanding and therapeutic management of new and innovative processes. One example of this would be the arrival of new direct oral anticoagulants (DOACs), which require novel approaches to measurement completely different from those applicable to vitamin K antagonists. Their introduction was one of the drivers behind the development of this more sophisticated, fully automated analyser.
Professor Hendrik Coenraad Hemker, from the Cardiovascular Research Institute in Maastricht, and a world expert in haemostasis, reminds us of the importance of continuous thrombin generation analysis with his anecdote “the more thrombin, the more thrombosis but the less bleeding, the less thrombin the less thrombosis but more bleeding”. This careful balance is what the ST Genesia seeks to measure.
Limitations of current coagulation tests
Several basic laboratory techniques are currently used for measuring the haemostatic function of the blood to diagnose and monitor bleeding and thrombotic disorders. They are diagnosed by analysis of the blood coagulation process, using either a global test (ie clotting time) or an analytical test, which looks specifically at the different components of coagulation.
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