Calibrated automated thrombogram

The calibrated automated thrombogram (CAT or CT) is a thrombin generation assay (TGA) and global coagulation assay (GCA) which can be used as a coagulation test to assess thrombotic risk.^[1][2] It is the most widely used TGA.^[3] The CAT is a semi-automated test performed in a 96-well plate and requires specialized technologists to be performed.^[3] As a result, it has seen low implementation in routine laboratories and has been more limited to research settings.^[3][4] Lack of standardization with the CAT has also led to difficulties in study-to-study comparisons in research.^[3][5] However, efforts have recently been made towards standardization of the assay.^[5][6][7][8] An example of a specific commercial CAT is the Thrombinoscope by Thrombinoscope BV (now owned by Diagnostica Stago).^[9]

The CAT can be used to measure thrombogram parameters such as the endogenous thrombin potential (ETP)^[2][10] and to assess activated protein C resistance (APCR).^[5] The CAT ETP-based APC resistance test is especially sensitive to estrogen-induced procoagulation, such as with combined oral contraceptives.^[2][5][11]

In 2018, a commercial fully-automated TGA system and alternative to the CAT called the ST Genesia debuted.^[3] It has been said that this system should allow for more widespread adoption of TGAs in clinical laboratories.^[3][12] The ST Genesia system also shows improved reproducibility compared to the CAT.^[3]