Thrombin
proteinThrombin is generated by tissue-factor-triggered coagulation and drives fibrin polymerization and platelet activation in coronary thrombosis.
Pathway placement
Cascade stepCoagulation & thrombus formation
Confidencehigh
RationaleThrombin is the central coagulation protease; driver of fibrin formation in arterial thrombosis.
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresType-II-associated
R — rupture / Type-I—
C — confounder / Type-II75
A — assay feasibility68
E — evidence strength42
T1DI (composite)6
Specificity differential (R−C)-60
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 3
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 2
4tachyarrhythmian/a
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 2
7high-demand / peri-operative stressn/a
Coverage: 4/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 12 supporting references. See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)
Method / principle
Sandwich immunoassay (ELISA) — research-grade unless a cleared assay exists
Reagent / substrate
Matched anti-target antibody pair (capture + labeled detection)
Platform
ELISA microplate or multiplex (Luminex/MSD)
Turnaround · availability
Send-out / research · Research-grade (no universal clinical assay)
Literature evidence(25)
- D-Dimer as Biomarker for Prognosis of Coronary Artery Disease and Heart Failure: Reappraisal of Its Central Role.Cardiology · 2025 · PMID 40340891 · doi
- Key markers and detection methods for evaluating platelet dysfunction in mechanical circulatory support devices.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025 · PMID 40730707 · doi
- Fibrin Monomer in Thrombosis and Haemostasis: A Clinical Biomarker and Beyond.International journal of molecular sciences · 2025 · PMID 41465254 · doi
- Thrombin Generation Is Associated With Extracellular Vesicle and Leukocyte Lipid Membranes in Atherosclerotic Cardiovascular Disease.Arteriosclerosis, thrombosis, and vascular biology · 2024 · PMID 39087349 · doi
- On-Chip Platelet Activation Assessment: Microfluidic Emulation of Shear Stress Profiles Induced by Mechanical Circulatory Support Devices.Methods in molecular biology (Clifton, N.J.) · 2022 · PMID 34520014 · doi
- Thrombin generation assay as a biomarker of cardiovascular outcomes and mortality: A narrative review.Thrombosis research · 2022 · PMID 36334397 · doi
- Biomarkers of coagulation and fibrinolysis in acute myocardial infarction: a joint position paper of the Association for Acute CardioVascular Care and the European Society of Cardiology Working Group on Thrombosis.European heart journal. Acute cardiovascular care · 2021 · PMID 33620437 · doi
- Interaction between thrombin potential and age on early clinical outcome in patients hospitalized for COVID-19.Journal of thrombosis and thrombolysis · 2021 · PMID 34110529 · doi
- Fibrin clot properties in coronary artery disease: new determinants and prognostic markers.Polish archives of internal medicine · 2021 · PMID 34623063 · doi
- Altered fibrin clot properties and fibrinolysis in patients with atrial fibrillation: practical implications.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2020 · PMID 31625555 · doi
- Patients with acute and chronic coronary syndromes have elevated long-term thrombin generation.Journal of thrombosis and thrombolysis · 2020 · PMID 32077007 · doi
- Thrombin generation's role in predicting coronary disease severity.PloS one · 2020 · PMID 32764787 · doi
- Thrombin-Mediated Degradation of Human Cardiac Troponin T.Clinical chemistry · 2017 · PMID 28428352 · doi
- Novel oral anticoagulants in the management of coronary artery disease.Coronary artery disease · 2016 · PMID 27228186 · doi
- Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events.PloS one · 2016 · PMID 27419389 · doi
- Is fibrin formation and thrombin generation increased during and after an acute coronary syndrome?Thrombosis research · 2011 · PMID 21496882 · doi
- Prostate-specific antigen, prostate cancer, and disorders of hemostasis.Seminars in thrombosis and hemostasis · 2009 · PMID 20013532 · doi
- Increased thrombin generation after acute versus chronic coronary disease as assessed by the thrombin generation test.Thrombosis and haemostasis · 2008 · PMID 18278189 · doi
- Thrombin inhibitor reduces myocardial infarction in apoE-/- x LDLR-/- mice.American journal of physiology. Heart and circulatory physiology · 2004 · PMID 15031124 · doi
- [Fibrinogen and atherothrombosis: vulnerable plaque or vulnerable patient?].Herz · 2003 · PMID 14569394 · doi
- Platelet-dependent and procoagulant mechanisms in arterial thrombosis.International journal of cardiology · 1999 · PMID 10328604 · doi
- Streptokinase-induced activation of the kallikrein-kinin system and of the contact phase in patients with acute myocardial infarction.Journal of cardiovascular pharmacology · 1998 · PMID 9593077 · doi
- Plasmin-mediated activation of contact system in response to pharmacological thrombolysis.Circulation · 1995 · PMID 7805216 · doi
- Thrombin generation in myocardial infarction and hypercholesterolemia: effects of aspirin.Thrombosis and haemostasis · 1995 · PMID 8578530
- Thrombin generation in human coronary arteries after percutaneous transluminal balloon angioplasty.Journal of the American College of Cardiology · 1994 · PMID 7930280 · doi
Clinical trials(1)
- Assessment of Thrombotic Status in Patients With Acute Coronary SyndromeNCT02562690 · UNKNOWN · Thrombin generation assays, TEG and GTT