PB1108 - Thrombin Generation Using the ST-Genesia System in a Cohort of Healthy Asian Adults: Absolute and Normalized Values

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

Bingwen Eugene Fan, MBBS, MRCP, MMED

Consultant
Department of Haematology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
MA

Mui Kia Ang

Senior Medical Technologist
Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore
Singapore, Singapore

Presenting Author(s)

Hwee Tat Tan

Senior Medical Technologist
Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore
Singapore, Singapore

Co-Author(s)

JB

Jerome Boulaire

Manager
All Eights (Singapore) Pte Ltd
Singapore, Singapore
TC

Tan Li Chai

Manager
All Eights (Singapore) Pte Ltd
Singapore, Singapore
KO

Kiat Hoe Ong

Senior Consultant
Department of Haematology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
VS

Venkata Sreekanth Sampath

Senior Consultant
Department of Haematology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
CS

Christina Lai Lin SUM

Principal Medical Technologist
Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore
Singapore, Singapore

Background: The thrombin generation assay (TGA) is a global haemostatic test widely utilized to investigate both diseases and drugs that cause thrombosis and bleeding.

Aims: To establish the reference intervals for TGA in healthy Asian adults and measure the variability of 3 standardised tests: STG-BleedScreen, STG-DrugScreen and STG-ThromboScreen.

Methods: Whole blood was obtained from 125 healthy Asian adults aged 18 to 65 years (Chinese (71.2%, n=89), Indians (8%, n=10), Malays (15.2%, n=19), Filipinos (4.8%, n=6) and others (0.8%, n=1)). 51.20% (n=65) were women. TGA was performed on platelet poor plasma using the ST-Genesia (STG) (Stago, Asnières-sur-Seine, France). 125 samples were assayed using the STG-BleedScreen and STG-ThromboScreen, with 62 samples measured using the STG-DrugScreen. Subgroup analysis of sex and race was performed.

Results: Reference ranges were established with both normalized and absolute TG parameters (Table 1, Table 2). STG bleed screen (normalized) had a lag time ratio 1.07±0.2, peak height 103.72±31.4%, time to peak ratio 1.12±0.1, ETP 101.59±22.1%, Vel. Index 95.90±37.5%, start tail ratio 0.99±0.1 min. STG drug screen (normalized) had a lag time ratio 1.00±0.17, peak height 96.52±9.29%, time to peak ratio 1.01±0.12, ETP 88.98±12.72%, Vel. Index 99.51±18.35%, start tail ratio 0.90±0.08 min. STG Thromboscreen (without thrombomodulin) (normalized) had a lag time ratio 1.11±0.19, peak height 84.19±20.14%, time to peak ratio 1.23±0.17, ETP 93.51±15.06%, Vel. Index 73.30±30.09%, start tail ratio 1.08±0.15 min. STG Thromboscreen (with thrombomodulin) (absolute) had a lag time 2.42±0.47 min, peak height 101.57±46.51%, time to peak 4.31±0.63 min, ETP 427.75±189.04 nM.min, ETP Inhibition 64.85±13.22%, Vel. Index 77.19±40.66 nm/min, start tail 13.63±0.97 min. The coefficient of variation for ETP was lower than the reported 23% and the ETP was decreased by 65% when TM was added. Intergender and interethnic variation were not statistically significant.

Conclusion(s): STG appears to be suitable for the accurate measurement of TG in healthy Asian adults.