Campus Centro Oeste - Universidade Federal de São João del-Rei, Divinópolis, Brazil.
Campus Centro Oeste - Universidade Federal de São João del-Rei, Divinópolis, Brazil; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy - Universidade Federal de Minas Gerais, Brazil.
Thromb Res. 2022 Dec;220:107-115. doi: 10.1016/j.thromres.2022.10.007. Epub 2022 Oct 13.
Cardiovascular diseases (CVDs) are currently the leading cause of death worldwide. Therefore, there is interest in the search for cardiovascular risk markers that contribute to the early diagnosis, monitoring and prevention of cardiovascular events. Considering that CVDs present in their pathophysiology a strong interaction between inflammation and hemostasis, thrombin, a key enzyme in the clotting process can be thought as a possible biomarker of cardiovascular risk. The thrombin generation assay (TGA) by the Calibrated Automated Thrombogram (CAT) method has been used in numerous prospective studies. It is a relatively recent laboratory tool capable of globally evaluating the functioning of the hemostatic system through the determination of thrombin generation for investigating the contribution of procoagulants and natural anticoagulants, in addition to the effect of different drugs and a range of factors that interfere in this system. The analysis of thrombin generation can be a promising tool for estimating the risk of thrombotic diseases, although the association of TGA with arterial thrombosis has only recently attracted interest and remains to be better understood. The association between thrombin generation and cardiovascular events, especially acute myocardial infarction (AMI) and stroke, all-cause and cardiovascular mortality is still poorly investigated and the results are often inconsistent. Assessing the relationship between TGA and CVDs may not only contribute to increasing knowledge of the pathophysiological process that leads to coronary and cerebrovascular diseases, but may also suggest a new approach to prevention. In this article we review and summarize the results of the main studies that evaluated whether TGA parameters were associated with cardiovascular events, cardiovascular mortality and all-cause mortality. Possible contributing factors to the observed inconsistencies were also speculated.
心血管疾病（CVDs）是目前全球范围内的主要死因。因此，人们对寻找有助于心血管疾病早期诊断、监测和预防的心血管风险标志物产生了兴趣。鉴于 CVDs 在其病理生理学上表现出炎症和止血之间的强烈相互作用，凝血酶作为凝血过程中的关键酶，可以被认为是心血管风险的一个潜在生物标志物。基于 Calibrated Automated Thrombogram（CAT）方法的凝血酶生成检测（TGA）已在众多前瞻性研究中得到应用。这是一种相对较新的实验室工具，通过测定凝血酶生成来全面评估止血系统的功能，从而研究促凝物和天然抗凝剂的作用，以及不同药物和一系列干扰该系统的因素的影响。分析凝血酶生成可能是评估血栓性疾病风险的有前途的工具，尽管 TGA 与动脉血栓形成的关联最近才引起关注，仍有待进一步了解。凝血酶生成与心血管事件（尤其是急性心肌梗死（AMI）和中风）、全因和心血管死亡率之间的关联仍未得到充分研究，结果往往不一致。评估 TGA 与 CVDs 之间的关系不仅有助于增加对导致冠状动脉和脑血管疾病的病理生理过程的认识，还可能为预防提供新方法。本文综述和总结了评估 TGA 参数与心血管事件、心血管死亡率和全因死亡率之间是否存在关联的主要研究结果，并推测了导致观察结果不一致的可能因素。
