The Hypercoagulable State: A Study of Clot Waveform Analysis, Thrombin Generation, and Clot Scanning Electron Microscopy.
Context.--Clot waveform analysis (CWA) is a method that provides a detailed view of the clotting process for simple clotting tests such as prothrombin time (PT) or activated partial thromboplastin time (aPTT). Coagulometers with optical clot detection systems capture detailed information during each...
| Published in: | Archives of Pathology & Laboratory Medicine Vol. 150; no. 2; pp. 146 - 155 |
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| Main Authors: | , , , , , , , , , |
| Format: | pictorial research tables/charts Journal Article |
| Published: |
College of American Pathologists
Feb2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191474376&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191474376 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: Feb2026 vid: 150 iid: 2 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 191474376 191474376 191474376 10.5858/arpa.2024-0298-OA 191474376 ppf: 146 ppct: 9 formats: fmt: @attributes: type: P tig: atl: The Hypercoagulable State: A Study of Clot Waveform Analysis, Thrombin Generation, and Clot Scanning Electron Microscopy. aug: au: Ruberto, Maria Filomena Marongiu, Silvia Congiu, Terenzio Barberini, Luigi Conti, Maria Porcu, Carmen Ntoukas, Dimitrios Marco Faa, Gavino Marongiu, Francesco Barcellona, Doris affil: Laboratory Department, Madonna del Rimedio Hospital, Oristano, Oristano, Italy sug: subj: Thrombosis Diagnosis Blood Coagulation Tests Methods Microscopy, Electron, Scanning Utilization Waveforms Thrombin Human Italy Female Male Comparative Studies Nonexperimental Studies Blood Specimen Collection Scales Adult Middle Age Aged Kruskal-Wallis Test Analysis of Variance Post Hoc Analysis Data Analysis Software Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Context.--Clot waveform analysis (CWA) is a method that provides a detailed view of the clotting process for simple clotting tests such as prothrombin time (PT) or activated partial thromboplastin time (aPTT). Coagulometers with optical clot detection systems capture detailed information during each analysis, which can be used for CWA at no additional reagent expense. Objective.--To investigate (1) whether CWA can detect a hypercoagulable state in different clinical conditions similar to the thrombin generation (TG) assay, and (2) whether there are differences in the texture of in vitro clots by scanning electron microscopy (SEM). Design.--PT INR (international normalized ratio), aPTT ratio, CWA, D-dimer, fibrinogen, von Willebrand factor antigen (vWF:Ag), von Willebrand factor ristocetin cofactor (vWF:RiCo) activity, TG assays, and clot scans by SEM were obtained for 191 patients (65 with COVID-19, 51 with systemic sclerosis, 51 with liver cirrhosis, 13 with high Padua Prediction Score [PPS] without antithrombotic prophylaxis, and 11 with low PPS). A texture analysis for images acquired by SEM was performed with MATLAB software. Data are described as median and range. Results.--Compared to healthy controls, patients with COVID-19, systemic sclerosis, high PPS, and low PPS had higher levels of CWA, fibrinogen, D-dimer, and TG, as well as thicker clots by SEM. The highest values of both vWF:Ag and vWF:RiCo were found in patients with COVID-19. Conclusions.--We have shown that similar to the TG assay, CWA can detect a hypercoagulable state in patients at increased risk of clotting. Furthermore, we identified differences of in vitro clot texture by SEM that may provide further insight into the underlying pathology. Even though CWA is currently considered a research tool, it might one day become a clinically accepted test and provide value-added information to PT or aPTT testing at minimal computational costs. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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