Global assays of hemostasis in the diagnostics of hypercoagulation and evaluation of thrombosis risk

摘要: Thrombosis is a deadly malfunctioning of the hemostatic system occurring in numerous conditions and states, from surgery pregnancy to cancer, sepsis infarction. Despite availability antithrombotic agents vast clinical experience justifying their use, thrombosis still responsible for lion’s share mortality morbidity modern world. One key reasons behind this notorious insensitivity traditional coagulation assays hypercoagulation inability evaluate thrombotic risks; specific molecular markers are more successful but suffer disadvantages. A possible solution proposed by use global, or integral, that aim mimic reflect major physiological aspects hemostasis process vitro. Here we review existing evidence regarding ability both established novel global (thrombin generation, thrombelastography, thrombodynamics, flow perfusion chambers) risk disorders. The biochemical nature its detectability analysis blood state principle also discussed. We conclude have potential be an important tool diagnostics. However, lack standardization currently impedes application: different modifications each assay vary sensitivity specificity pathology. In addition, it remains seen how (even when they can reliably detect groups with thrombosis) used decisions: difference between such statistically significant, not large.