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S2E11 - What is thrombin generation?

Presented by Audrey Carlo and Cécile Hourquet // Special guest Marisa Ninivaggi, research project leader at Synapse research institute

Season 2, episode 11
9 min / Published
By Stago

Welcome to Ask Stago, the podcast dedicated to provide expert answers to your expert questions in haemostasis. 

In today episode, our expert Marisa Ninivaggi, research project leader at Synapse research institute, will explain us what is thrombin generation. 

As usual, don’t forget to send any question you may have to Ask@stago.com, we will be glad to answer to it. 

Learn more  👇
Literature sources: 

  • Castoldi E, Rosing J. Thrombin generation tests. Thromb Res. 2011 Feb;127 Suppl 3:S21-5. doi: 10.1016/S0049-3848(11)70007-X 
  • Baglin T. The measurement and application of thrombin generation. Br J Haematol. 2005 Sep;130(5):653-61. doi: 10.1111/j.1365-2141.2005.05612.x. 
  • Hemker HC, Béguin S. Thrombin generation in plasma: its assessment via the endogenous thrombin potential. Thromb Haemost. 1995 Jul;74(1):134-8. Erratum in: Thromb Haemost 1995 Nov;74(5):1388. 
  • Duarte RCF, Ferreira CN, Rios DRA, Reis HJD, Carvalho MDG. Thrombin generation assays for global evaluation of the hemostatic system: perspectives and limitations. Rev Bras Hematol Hemoter. 2017;39(3):259-265. doi:10.1016/j.bjhh.2017.03.009 
  • Al Dieri R, de Laat B, Hemker HC. Thrombin generation: what have we learned? Blood Rev. 2012 Sep;26(5):197-203. doi: 10.1016/j.blre.2012.06.001. 
  • Hemker HC. Recollections on thrombin generation. J Thromb Haemost. 2008 Feb;6(2):219-26. doi: 10.1111/j.1538-7836.2007.02864.x. 
  • Macfarlane, R. & Biggs, R. (1953) A thrombin generation test; the application in haemophilia and thrombocytopenia. Journal of Clinical Pathology, 6, 3–8 
  • de Laat‐Kremers, RMW, Ninivaggi, M, Devreese, KMJ, de Laat, B. Towards standardization of thrombin generation assays: Inventory of thrombin generation methods based on results of an International Society of Thrombosis and Haemostasis Scientific Standardization Committee survey. J Thromb Haemost. 2020; 18: 1893– 1899. https://doi.org/10.1111/jth.14863
  • Waters EK, Hilden I, Sørensen BB, Ezban M, Holm PK. Thrombin generation assay using factor XIa to measure factors VIII and IX and their glycoPEGylated derivatives is robust and sensitive. J Thromb Haemost. 2015 Nov;13(11):2041-52. doi: 10.1111/jth.13134.. 
  • Poitevin S, Cochery-Nouvellon E, Dupont A, Nguyen P. Monocyte IL-10 produced in response to lipopolysaccharide modulates thrombin generation by inhibiting tissue factor expression and release of active tissue factor-bound microparticles. Thromb Haemost. 2007 Apr;97(4):598-607. 
  • Tripodi A. Usefulness of Thrombin Generation. Hamostaseologie. 2020 Nov;40(4):509-514. doi: 10.1055/a-1200-0417. 
  • https://pubmed.ncbi.nlm.nih.gov/?term=thrombin+generation&sort=date accessed April 23, 2021 
  • Marchetti M, Giaccherini C, Masci G, Verzeroli C, Russo L, Celio L, Sarmiento R, Gamba S, Tartari CJ, Diani E, Vignoli A, Malighetti P, Spinelli D, Kuderer NM, Nichetti F, Minelli M, Tondini C, Barni S, Giuliani F, Petrelli F, D'Alessio A, Gasparini G, Labianca R, Santoro A, De Braud F, Falanga A; HYPERCAN Investigators. Thrombin generation predicts early recurrence in breast cancer patients. J Thromb Haemost. 2020 Sep;18(9):2220-2231. doi: 10.1111/jth.14891  
  • Gomez-Rosas P, Pesenti M, Verzeroli C et al Validation of the Role of Thrombin Generation Potential by a Fully Automated System in the Identification of Breast Cancer Patients at High Risk of Disease Recurrence · TH Open 2021; 05(01): e56-e65 DOI: 10.1055/s-0040-1722609 
  • Metze M, Pfrepper C, Klöter T, Stöbe S, Siegemund R, Siegemund T, Edel E, Laüfs U, Petros S,  Inhibition of thrombin generation 12 hours after intake of direct oral anticoagulant, Res Pract Thromb Haemost 2020  doi: 10.1002/rth2.12332   
  • Douxfils J, Morimont L, Bouvy C. Oral Contraceptives and Venous Thromboembolism: Focus on Testing that May Enable Prediction and Assessment of the Risk. Semin Thromb Hemost. 2020 Nov;46(8):872-886. doi: 10.1055/s-0040-1714140. 
  • Zermatten MG, Bertaggia Calderara D, Aliotta A, Alberio L, Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report Res Pract Thromb Haemost  2020 doi: 10.1002/rth2.12318 
  • Talon L, Sinegre T, Lecompte T, Pereira B, Massoulié S, Abergel A, Lebreton A, Hypercoagulability (thrombin generation) in patients with cirrhosis detected with ST Genesia, J Thromb Haemost 2020 doi: 10.1111/JTH.14963   
  • Dargaud Y, Lienhart A, Janbain M, Le Quellec S, Enjolras N, Negrier C. Use of thrombin generation assay to personalize treatment of breakthrough bleeds in a patient with hemophilia and inhibitors receiving prophylaxis with emicizumab. Haematologica. 2018 Apr;103(4):e181-e183. doi: 10.3324/haematol.2017.185330.  
  • Calzavarini S, Brodard J, Quarroz C, Maire L, Nützi R, Jankovic J, Rotondo LC, Fiedler GM, Nagler M, Angelillo-Scherrer A, Thrombin generation measurement using the ST Genesia Thrombin Generation System in a cohort of healthy adults: Normal values and variability, Res Pract Thromb Haemost 2019; 00: 1-11 doi: 10.1002/rth2.12238 
  • Ninivaggi, M, de Laat‐Kremers, RMW, Carlo, A, de Laat, B. ST Genesia reference values of 117 healthy donors measured with STG‐BleedScreen, STG‐DrugScreen and STG‐ThromboScreen reagents. Res Pract Thromb Haemost. 2020; 00: 1– 10. https://doi.org/10.1002/rth2.12455
  • Foulon-Pinto G, Jourdi G, Perrin J, Abdoul J, Paris G, Gouin-Thibault I, Curis E, Lecompte T, Siguret V. Study of thrombin generation with St Genesia to evaluate xaban  pharmacodynamics: Analytical performances over 18 months. Int J Lab Hematol. 2020 Dec 28. doi: 10.1111/ijlh.13443 
  • Tripodi A. Thrombin Generation Assay and Its Application in the Clinical Laboratory. Clin Chem. 2016 May;62(5):699-707. doi: 10.1373/clinchem.2015.248625. 


Content is scientific and technical in nature. It is intended as an educational tool for laboratory professionals and topics discussed are not intended as recommendations or as commentary on appropriate clinical practice. 

  • coagulation
  • hemostasis
  • thrombin generation
  • global assay
  • clinical application
  • thrombosis
  • bleeding
  • ask stago
The show team
Cecile Hourquet
Cecile Hourquet
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