Soluble clotting factors and the coagulation response: an in vitro study

Clinically, the dissolution of pathologic blood clots through conventional therapeutics may alter patient coagulation profile and increase risk of thrombohaemorrhagic complications. We developed an in vitro model to determine the effect of soluble clotting factors on coagulation response. Blood clot solubles were added at an approximate 1:1000 dilution to matched human whole blood samples (n = 10). The clotting time and clot rate were measured using a Sonoclot® Coagulation Analyzer and compared with relevant controls. Two tailed paired t tests indicated a significant increase in clot rate and a significant decrease in clotting time between control and "spiked" groups (p<0.05). Even at dilute concentrations, soluble clotting factors significantly potentiate the rate of clot formation. The assay described may provide a method for monitoring patient coagulation profile during mechanical thrombectomy and/or fibrinolytic therapy. The implementation of this technique as part of a novel, clinical coagulation test warrants further study.