Applications for CORA Technology

Normal hemostasis is a complex, dynamic balance between procoagulant and anticoagulant systems involving more than 50 distinct proteins. When the system is in balance, clots form at the right place and the right time, have the proper strength, and then dissolve over time.

Abnormalities in hemostasis can lead to:

  • Heart attack
  • Pulmonary embolism
  • Deep vein thrombosis
  • Stroke (80% ischemic/clot in brain; 20% hemorrhagic/bleeding in brain)
  • Excessive bleeding

Because so many factors are involved, and none works in isolation, assessing hemostasis is a challenge that requires a global, whole-blood test that can see beyond individual factors. Only thrombelastography—the basis for the CORA™ system—provides such a comprehensive view.

The CORA system will allow patients to be screened for risk of heart attack or stroke in hospitals, physician offices, clinics, battlefields and other places where they receive care, leading to better patient outcomes and fewer complications. In fact, thrombelastography has been found to be superior to aggregometry, used in VerifyNow® and Multiplate® products.*

CORA technology can be used to improve patient outcomes—while saving critical time and money—in a number of areas, including:

Reducing Bleeding and Blood Product Use

The CORA system is intended to lessen the need for blood products—to assist in improving patient outcomes as well as lessening hospitals’ dependence on inadequate, unpredictable supplies.

Within the hospital, one in seven patients receives blood products, with a massive associated cost in both lives and dollars, as transfusions are associated with a dramatically increased incidence of death, heart attack and stroke.* What’s more, as populations age and treatments become more advanced, demand for blood products is increasing. However, supply is not keeping up with demand, and there are no reliable processes in place for predicting blood demand or optimizing resources.

CORA technology can be used to improve patient outcomes—while saving critical time and money—in a variety of ways throughout point-of-care settings.

Using thrombelastography to monitor a patient’s hemostasis during surgery can help surgeons determine if a patient will need a transfusion, enabling a more informed choice of treatment. It has been shown to significantly reduce bleeding and the need for transfusion, not to mention saving more than 50% in blood product use.*

Preventing Heart Attack and Stroke

Managing patients at high risk for ischemic events is one of the top concerns of family practice physicians, internists and cardiologists. After all, as the number of people with obesity increases, high blood pressure, high cholesterol and diabetes also continue to rise. As a result, cardiovascular disease has become the fastest-growing health problem in the United States. The American Heart Association is now calling for management of cardiovascular health, rather than cardiovascular disease, and focusing on prevention. The CORA system will support these goals through screening and risk stratification for ischemic events, to assist in drug dose control, prevention and management of bleeding and thrombotic risk, and appropriate treatment to prevent recurrence.

In fact, studies of surgical and cardiac patients showed that thrombelastography is able to detect and quantify a hypercoagulable state and can be used to predict—with nearly 90% accuracy—which patients are at greatest risk of ischemic events.*

Hyperfibrinolysis Treatment

The breakdown of a clot is an essential part of the healing process. Bleeding can occur when clots break down too quickly, in a condition known as primary hyperfibrinolysis. Mistreatment of hyperfibrinolysis in a hypercoagulable patient can be fatal, because antifibrinolytic drugs inhibit clot breakdown and can lead to massive clotting. The CORA system is designed to provide data and guidance to allow physicians to more clearly distinguish between primary and secondary hyperfibrinolysis, leading to safer and more effective treatment.*

Drug Dose Management

Patients with implanted coronary stents, as well as others with high platelet function, are routinely prescribed a regimen of Plavix® and aspirin therapy to prevent clots from forming. Understanding clotting behavior using the CORA system will allow physicians to individualize dosing of Plavix or other platelet inhibitors and anticoagulants. As a result, doctors may be able to increase dosages or change drugs when patients are not responding adequately, or decrease or discontinue therapy to prevent bleeding for over-responders or those not requiring the drug.*

Monitoring Hemostasis-Altering Devices

The CORA system may also be used to monitor DES patients for stent thrombosis, or the formation of a clot in the stent, and to screen dialysis patients for stenosis.

Emergency Response Care

First responders can benefit greatly from immediate, on-site diagnoses for rapid intervention decisions in cases of heart attack and stroke or in bleeding patients who have no wound evident. Because the CORA system is immune to external vibration, it will be more easily adapted to ambulance or battlefield use than other products.

Personalized Hemostasis Therapy

The CORA system is designed to allow physicians to provide true personalized hemostasis therapy, made safe and effective with reliable testing in the hospital and their own offices. The instrument will assist in diagnosis, screening, therapy guidance and status monitoring for a vast patient population.

The key strength of the CORA system will be its ability to stratify patient risk for ischemic and bleeding events.* This may allow physicians to take steps to mitigate that risk through medication or behavior modification, ultimately preventing possible heart attacks and strokes.

Ultimately, CORA technology will be found throughout patient point-of-care settings and across the continuum of care.

*Data on file.

Coumadin is a registered trademark of Bristol-Myers Squibb. Multiplate is a registered trademark of Verum Diagnostica GmbH. Plavix is a registered trademark of Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership. VerifyNow is a registered trademark of Accumetrics, Inc.

Clinical Value

The CORA system measures all phases of hemostasis to assist in risk assessment of ischemic or bleeding events.