Past and present screening assays to evaluate hemostasis
Disclosure : Unrestricted education grants from Baxter, Novo Nordisk, Csl Behring.
R&D grant from Dade Behring, a Siemens company.
27 slide(s) – 00:25:45 – English – 2008-06-13
The aim of this presentation is to give an overview about pro and cons of the currrent screening assays to detect abnormalities in hemostasis. Secondly, new initiatives to screen for hemostatic abberations will be discussed.
Detection of aberrations in haemostasis relies on screening assays that cover the different compartments of the haemostatic process. For screening primary haemostatic abnormalities the bleeding time is traditionally most widely performed. Due to its many disadvantages of this assay new assays are getting more popular including tools like the platelet function analyzer and the fully automated platelet aggregometers. Both measure platelet-related abnormalities under different conditions. Screening secondary haemostasis abnormalities, including the presence of acquired inhibitors, depends largely on clotting tests made sensitive for specific parts of the coagulation cascade. Most popular are the Prothrombin Time, Activated Partial Thromboplastin Time and Thrombin Time. Limitations of these screening tests are that these assays only measure the initial phase of the clotting cascade (initial fibrin formation), are relative insensitive to mild coagulation abnormalities and lack the ability to screen an increased thrombophilic imprint. In the last decade much attention has been paid to new overall assays determining total thrombin generation or clot waveform analysis. New possibilities are expected with the next generation of screening assays combining multiple component analyses of the haemostatic balance together with nanotechnology and Point of Care detection.