Abstract

Thrombin is a key enzyme of the coagulation cascade, having both pro- and anticoagulant functions. Global haemostasis assay, the so-called thrombin generation test is appropriate for its assessment. Estimation of an individual's potential to generate thrombin may correlate more closely with a hyper- or hypo-coagulable phenotype, compared to traditional coagulation tests. In patients at risk of venous thrombosis, thrombin generation analysis may be utilized to detect underlying thrombophilia. In patients with documented venous thromboembolism, increased thrombin generation values are seen in those patients at greatest risk for recurrence. In patients with arterial vascular disease, the data are limited. In case of haemophilia thrombin generation assays reflect bleeding severity. It is applicable for monitoring of both conventional haemophilia treatment and inhibitor-bypassing therapy, which is needed when inhibitors develop in patients. Standardization of thrombin generation methods and determination of cut off-values are required before its application in clinical practice.

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