Thrombin Generation Assay in Antiphospholipid Antibodies Positive Subjects as a Personalized Thrombotic Risk Assessment: State of the Art and Perspectives

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发表日期：

2024年2月19日

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Thomas Foret,
Virginie Dufrost,
Jeremy Lagrange,
Patricia Costa,
Guillaume Mourey,
Thomas Lecompte,
Nadine Magy-Bertrand,
Veronique Regnault,
Stéphane Zuily,
Denis Wahl

摘要

Purpose of the Review

Thrombotic risk assessment in antiphospholipid positive (aPL +) subjects is a major challenge, and the study of in vitro thrombin generation (thrombin generation assays (TGA)) could provide useful information. Activated protein C (APC) sensitivity is involved in thrombotic events in antiphospholipid syndrome patients. We summarized methods used to assess APC sensitivity with TGA and evaluated the prognostic role of APC resistance through literature search.

Recent Findings

APC resistance induced by aPL is a complex pathway. Several cross-sectional studies assessed APC sensitivity to understand thrombotic event mechanisms in aPL + subjects. Only one prospective cohort had investigated the prognostic impact of APC resistance in aPL + subjects, with a positive and significant correlation between APC sensitivity and the risk of thrombosis during the follow up (hazard ratio, 6.07 [95% CI, 1.69–21.87]).

Summary

APC resistance assessed with TGA could be associated with thrombotic events in aPL + subjects.