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Keywords:

  • thrombelastograph;
  • thrombin generation;
  • whole blood clotting

Summary.  The objective of this study was to evaluate the possibility of linking the tracing of whole blood clotting in a thrombelastograph® (TEG®) hemostasis system with the generation of thrombin assessed by thrombin/antithrombin complex (TAT). Citrated whole blood containing corn trypsin inhibitor from volunteers was clotted in the presence of CaCl2 and tissue factor. Clotting was monitored with the eight channels of a TEG® system. At different time points, the whole blood TEG® reaction cups were kept in a cold quenching solution, centrifuged, and the supernatants were kept at −80 °C until assayed for TAT by ELISA. The total thrombus generation (TTG) was calculated from the first derivative of the TEG® waveform and was compared with thrombin generation measured by TAT. The two vector values – the TAT thrombin generation data and the corresponding TEG® TTG – were analyzed using Pearson correlation coefficients (r) and linear, non-linear and natural log (ln) transformation of TAT values for least-squares goodness-of-fit curves. The best least-squares fit is an exponential curve. Linearizing using the ln of the TAT thrombin generation variable produces the same r (0.94) as of the exponential curve. The prediction equation is y = 8.0465 + 0.0005x (P ≤ 0.0001), where y is the TAT thrombin generation variable in the ln transformation and x is the TEG® TTG variable. The high magnitude of r and the high significance of the prediction equation demonstrate the high efficacy of the prediction of TAT thrombin generation by the use of TEG® TTG.