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Overall hemostatic potential
Overall hemostatic potential
Synonyms	Overall hemostasis potential; Overall haemostasis potential; Overall haemostatic potential; OHP
Test of	Coagulation, hypercoagulability, hypocoagulability, hemostasis, fibrinolysis

The overall hemostatic potential (OHP) test is a global coagulation assay which can be used to measure coagulation.^[1]^[2]^[3]^[4] The OHP assay measures total fibrin generation in the presence of thrombin or tissue factor and tissue plasminogen activator (t-PA).^[2]^[1]^[3]^[4] It generates a fibrin time curve through the use of optical density measurement.^[1] This curve represents the balance between fibrin formation induced by thrombin or tissue factor and fibrinolysis induced by t-PA.^[1] The assay provides three parameters: overall coagulation potential (OCP), overall hemostatic potential (OHP), and overall fibrinolytic potential (OFP).^[2]^[1]^[4] OHP is the main parameter, while OCP and OFP are supplementary parameters to assess coagulation and fibrinolysis.^[3] One further parameter, clot lysis time (CLT), can also be determined.^[3] The OHP assay measures the integrated effect of procoagulant, anticoagulant, and fibrinolytic factors.^[1]

The OHP is a technically simple^[1]^[3] but relatively labor-intensive assay.^[2] As of 2010, it had been implemented in several laboratories, but was not available commercially.^[3] The assay is novel in terms of its combined evaluation of both fibrin generation and fibrinolysis.^[1] The test is potentially useful in the evaluation of hypercoagulability, hypocoagulability, and fibrinolytic abnormalities.^[1]^[2]^[3] It is able to detect hypercoagulability associated with pregnancy and estrogen/progestogen hormone therapy.^[3]^[4] The test has also been used to study coagulation in feminizing hormone therapy in transgender women.^[5] However, more studies are needed to validate the test as a biomarker of thrombosis and other abnormalities of coagulation.^[2]^[3]^[4]

History

The original OHP assay was developed in Sweden by Blombäck and colleagues and was first described in 1999.^[1]^[6]^[7] It used thrombin to trigger coagulation.^[1] Since then, a modified version has been developed which can use either thrombin or tissue factor to trigger coagulation.^[1]^[3]^[8]^[9]

References

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l Curnow J (2017). "The Overall Hemostatic Potential (OHP) Assay". Hemostasis and Thrombosis. Methods Mol Biol. Vol. 1646. pp. 523–531. doi:10.1007/978-1-4939-7196-1_38. ISBN 978-1-4939-7194-7. PMID 28804852.
^ ^a ^b ^c ^d ^e ^f Lim HY, Donnan G, Nandurkar H, Ho P (January 2022). "Global coagulation assays in hypercoagulable states". J Thromb Thrombolysis. 54 (1): 132–144. doi:10.1007/s11239-021-02621-1. PMID 34997471. S2CID 245804095.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Antovic A (October 2010). "The overall hemostasis potential: a laboratory tool for the investigation of global hemostasis". Semin Thromb Hemost. 36 (7): 772–9. doi:10.1055/s-0030-1265294. PMID 20978998. S2CID 35249276.
^ ^a ^b ^c ^d ^e Antovic A (July 2008). "Screening haemostasis--looking for global assays: the Overall Haemostasis Potential (OHP) method--a possible tool for laboratory investigation of global haemostasis in both hypo- and hypercoagulable conditions". Curr Vasc Pharmacol. 6 (3): 173–85. doi:10.2174/157016108784912028. PMID 18673157.
^ Lim HY, Leemaqz SY, Torkamani N, Grossmann M, Zajac JD, Nandurkar H, Ho P, Cheung AS (July 2020). "Global Coagulation Assays in Transgender Women on Oral and Transdermal Estradiol Therapy". J Clin Endocrinol Metab. 105 (7): e2369 – e2377. doi:10.1210/clinem/dgaa262. PMID 32413907.
^ He S, Bremme K, Blombäck M (October 1999). "A laboratory method for determination of overall haemostatic potential in plasma. I. Method design and preliminary results". Thromb Res. 96 (2): 145–56. doi:10.1016/s0049-3848(99)00092-4. PMID 10574592.
^ He S, Antovic A, Blombäck M (September 2001). "A simple and rapid laboratory method for determination of haemostasis potential in plasma. II. Modifications for use in routine laboratories and research work". Thromb Res. 103 (5): 355–61. doi:10.1016/s0049-3848(01)00332-2. PMID 11553368.
^ Curnow JL, Morel-Kopp MC, Roddie C, Aboud M, Ward CM (March 2007). "Reduced fibrinolysis and increased fibrin generation can be detected in hypercoagulable patients using the overall hemostatic potential assay". J Thromb Haemost. 5 (3): 528–34. doi:10.1111/j.1538-7836.2007.02362.x. PMID 17166248. S2CID 25346726.
^ Curnow, J. L. (2010). Evaluation of the overall haemostatic potential assay for the diagnosis and management of hypercoagulable states (Doctoral dissertation, University of Sydney). https://scholar.google.com/scholar?cluster=17586055299192023070