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Thrombin generation assays (TGA) provide a comprehensive evaluation of coagulation; however, results can be influenced by preanalytical conditions, including the choice of blood collection tubes. Citrate-theophylline-adenosine-dipyridamole (CTAD) tubes are recommended by the manufacturer of the Ceveron\n                    <jats:sup>\u00ae<\/jats:sup>\n                    alpha TGA system due to their ability to inhibit platelet activation. Nevertheless, CTAD tubes are costly, less widely available, and not manufactured in small volumes suitable for specific patient populations, such as paediatric cohorts. To evaluate whether standard citrate tubes can serve as a viable alternative, we prospectively compared TGA parameters from blood collected in 3.2% sodium citrate tubes versus CTAD tubes in 12 healthy volunteers. Assays were performed using low and high phospholipid micelle concentrations (RC low\/RC high). Significant differences between citrate and CTAD were observed for all parameters with the RC low reagent. In contrast, only lag time showed significant differences with the RC high reagent. In conclusion, while citrate tubes may be used for TGA, the type of blood collection tube can influence measurements under specific assay conditions and should be considered a relevant factor when comparing and interpreting TGA results.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-64702-6","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:44:41Z","timestamp":1785516281000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of blood collection tubes on thrombin generation assay results: a comparison of citrate and CTAD"],"prefix":"10.1038","volume":"16","author":[{"given":"Stefan","family":"Ulbing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Dibiasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Wiegele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Quehenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"T\u00f6pper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Schaden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Gratz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"64702_CR1","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1515\/cclm-2017-1205","volume":"56","author":"G Lippi","year":"2018","unstructured":"Lippi, G. & Favaloro, E. 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FS has no conflict of interest.SK has no conflict of interest.CD has received speaker fees from EKOMED GmbH and financial support for the Podcast \u2018ClotTalk\u2019 from Arjo Austria, Roche Diagnostics, CSL Behring, Biomedica, AstraZeneca, Novo Nordisk Pharma, Mitsubishi Tanabe Pharma, and AOP Orphan Pharmaceuticals.MW has no conflict of interest. PQ has no conflict of interest. ES has received speaker fees from CSL Behring and AstraZeneca and financial support for the Podcast \u2018ClotTalk\u2019 from AOP Orphan Pharmaceuticals, Arjo Austria, AstraZeneca, Biomedica, CSL Behring, Ekomed, Mitsubishi Tanabe Pharma, Novo Nordisk Pharma, and Roche Diagnostics. FT has received honoraria from Viatris. JG is and Editorial Board Member for Scientific Reports and has received honoraria, research funding, and travel reimbursement from Alexion, AstraZeneca, Boehringer Ingelheim, CSL Behring, Instrumentation Laboratory, Johnson & Johnson, Mitsubishi Tanabe Pharma, Octapharma, Portola, and Takeda.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"23718"}}