PB0997 - Utility of Thrombin Generation Assay for inherited thrombophilia screening

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

ML

Mélanie Lecomte

PharmD, PhD
Service d’Hématologie biologique, Centre Hospitalier de Valenciennes, Valenciennes, France.
Valenciennes, Nord-Pas-de-Calais, France

Co-Author(s)

Laetitia Mauge, PharmD PhD

PharmD, PhD
Service d’Hématologie biologique, AP-HP, Hôpital européen Georges-Pompidou, F-75015, Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
Paris, Ile-de-France, France
SG

Sophie Gandrille

PharmD, PhD
Service d’Hématologie biologique, AP-HP, Hôpital européen Georges-Pompidou, F-75015, Université Paris Cité, Inserm U1140, F-75006 Paris, France
Paris, Ile-de-France, France
TQ

Thomas Quemeneur

Medical Doctor
Service de Néphrologie et Médecine Interne, Centre Hospitalier de Valenciennes, Valenciennes, France.
Valenciennes, Nord-Pas-de-Calais, France
CR

Clémentine Rousselin

Medical Doctor
Service de Néphrologie et Médecine Interne, Centre Hospitalier de Valenciennes, Valenciennes, France.
Valenciennes, Nord-Pas-de-Calais, France
JO

Justine Onraed

PharmD
Service d’Hématologie biologique, Centre Hospitalier de Valenciennes, Valenciennes, France.
Valenciennes, Nord-Pas-de-Calais, France

Presenting Author(s)

Joffrey Feriel, PharmD

Scientific Manager
Diagnostica Stago
ASNIERES-SUR-SEINE, Ile-de-France, France

Co-Author(s)

CH

Claire Hémar

PharmD, PhD
Service d’Hématologie biologique, Centre Hospitalier de Valenciennes, Valenciennes, France.
Valenciennes, Nord-Pas-de-Calais, France

Background: The thrombin generation assay (TGA) is a global dynamic test exploring the ability of a plasma sample to generate and inhibit thrombin over time. Various studies support the link between TGA results and the presence of laboratory thrombophilia risk factors. But these studies were conducted using analyzers in non-standardized conditions. The ST-Genesia® is a fully automated and standardized system for the measurement of thrombin generation. The STG®-Thromboscreen kit is intended for the evaluation of thrombotic phenotype.

Aims: We aim at evaluating the STG®-ThromboScreen kit on ST-Genesia® as a global screening test for the main inherited thrombophilia risk factors.

Methods: Platelet-poor citrated plasma samples of 90 patients with thrombophilia screening were studied. Inherited thrombophilia was defined as antithrombin (AT), protein C (PC) or protein S (PS) deficiencies genetically characterized, factor V Leiden or F2c.*97G>A variants. Several TGA parameters were studied including endogenous thrombin potential (ETP, nmol.min), normalized ETP (%), and ETP inhibition (%) (= (ETP without thrombomodulin – ETP with thrombomodulin)/(ETP without thrombomodulin)).

Results: ETP and normalized ETP were similar for patients with (n=53) and without (n=37) inherited thrombophilia (p≥ 0.05). There was also no statistically significant difference between ETP inhibition in the group with AT deficiency (n=5) and ETP inhibition in the group without risk factors. In contrast, ETP inhibition was significantly lower (p < 0.01) in the groups with Factor V Leiden and/or F2c.*97G>A variants (n=25), PC deficiency (n=17) or PS deficiency (n=6) compared with the group without risk factors. In particular, an inherited PS deficiency can be excluded if ETP inhibition was > 37% (sensitivity 100%, specificity 96.1%, AUC = 0.976).

Conclusion(s): ETP inhibition measured using the STG®-Thromboscreen kit on the ST-Genesia® could be an additional tool before PROS1 gene analysis for patients with moderate PS deficiency in the absence of relevant thrombosis history.