Clinical and Applied Thrombosis/Hemostasis (Mar 2020)

Update on the Clot Waveform Analysis

  • Hideo Wada MD, PhD,
  • Takeshi Matsumoto MD, PhD,
  • Kohshi Ohishi MD, PhD,
  • Katsuya Shiraki MD, PhD,
  • Motomu Shimaoka MD, PhD

DOI
https://doi.org/10.1177/1076029620912027
Journal volume & issue
Vol. 26

Abstract

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The activated partial thromboplastin time (APTT)–clot waveform analysis (CWA) was previously reported to be associated with the early detection of disseminated intravascular coagulation and was also reported to be able to measure very low levels of coagulation factor VIII activity. The software program for the analysis for the APTT-CWA allows the associated first and second derivative curves (first and second DCs) to be displayed. The first and second DC reflect the velocity and acceleration, respectively. The height of the first DC reflects the “thrombin burst” and bleeding risk, while that of the second DC is useful for detecting any coagulation factor deficiency and abnormal enhancement of coagulation by phospholipids. Activated partial thromboplastin time-CWA aids in making a differential diagnosis which is difficult to do using only the routine APTT. The CWA is currently used for many applications in the clinical setting, including the monitoring of hemophilia patients and patients receiving anticoagulant therapy and the differential diagnosis of diseases.