In Normal Controls, Both Age and Gender Affect Coagulability as Measured by Thrombelastography

Roeloffzen, Wilfried; Kluin-Nelemans, Hanneke C.; Mulder, André B.; Veeger, Nic J. G. M.; Bosman, Lotte; Wolf, Jtm de

doi:10.1213/ane.0b013e3181d31e91

Cited by 90 publications

(88 citation statements)

References 21 publications

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“…Female patients had higher MA levels than males (66.5 vs. 62.8, p < 0.001), which was consistent with Rafiq et al who reported that more female CABG patients presented with TEG-hypercoagulability and in healthy population female sex and older age are associated with hypercoagulability [6,20,21]. It has frequently been reported that women develop more severe strokes and have worse functional outcomes than men after ischemic stroke [22,23].…”

Section: Discussionsupporting

confidence: 83%

Thrombelastography Maximal Clot Strength Could Predict One-Year Functional Outcome in Patients with Ischemic Stroke

Yao¹,

Dong²,

Song³

et al. 2014

Cerebrovasc Dis

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Background: Elevated maximal clot strength, measured by thrombelastography (TEG) maximum amplitude (MA) has been associated with a higher risk for ischemic events in patients with coronary artery diseases. However, it has not been investigated in patients with cerebrovascular diseases. In the current study, we aimed to evaluate the predictive ability of TEG-MA in assessing the risk for ischemic event recurrence and the functional outcome after index ischemic stroke. Methods: This was a prospective observational study. Consecutive eligible patients with acute ischemic stroke were included and followed up for one year. Patients were stratified into tertile groups based on MA levels. TEG-hypercoagulability was deﬁned as an MA of ≥69 mm. Ischemic events were defined as a composite of ischemic stroke, myocardial infarction, or vascular death (excluding hemorrhagic death). The functional outcome was evaluatewd by modified Rankin Scale (mRS). Unfavorable functional outcome was defined as mRS ≥2. Results: Two hundred and eleven patients were enrolled with 27 lost to follow-up at one year contact. At baseline, 38 (18.0%) patients were TEG-hypercoagulopathy after the treatment of antiplatelets. Patients with higher tertile of MA were more likely to be females, and had lower hemoglobin levels, higher platelet counts, higher fibrinogen levels, higher white blood cell counts, as well as higher ESR and hsCRP levels. Patients in the third tertile group were more likely to have intracranial artery stenosis and large-vessel subtype stroke than those in the other two groups. Higher tertile of MA was also related to stroke severity in acute phase (higher NIHSS scores on admission and longer in-hospital stay). At one year of follow-up, a higher percentage of unfavorable functional outcome and a non-significant trend of higher ischemic event rate were observed in higher MA tertile groups. Multivariate logistic analysis revealed that higher MA level (OR = 1.192, p = 0.022) was an independent predictor for unfavorable one-year functional outcome. Other independent predictors included old age (OR = 1.119, p = 0.001), diabetes mellitus (DM) (OR = 4.280, p = 0.014), previous ischemic stroke/TIA history (OR = 4.953, p = 0.008), and higher NIHSS scores on admission (OR = 1.437, p = 0.001). Conclusions: We found that higher TEG-MA levels could predict an unfavorable functional outcome after index ischemic stroke. Further, large-scale studies are required to investigate the relationship between MA levels and risk of recurrent ischemic events in ischemic stroke patients.

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Section: Discussionsupporting

confidence: 83%

Thrombelastography Maximal Clot Strength Could Predict One-Year Functional Outcome in Patients with Ischemic Stroke

Yao¹,

Dong²,

Song³

et al. 2014

Cerebrovasc Dis

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“…Three studies reported the extent of association between thromboelastometry/thromboelastography parameters and conventional coagulation assays [31][32][33]. The details are reported in table 2.…”

Section: Correlation With Conventional Parameters Of Hemostasismentioning

confidence: 99%

“…Two studies focused on thromboelastography [32,33]. In a study enrolling 120 participants (50% female) of 49.5 years on average, Roeloffzen and colleagues [33] compared R time with the aPTT, K time with the hemoglobin level, aPTT and the fibrinogen level, α angle with aPTT and the fibrinogen level, MA with the fibrinogen level, SEMS with the fibrinogen level, the CI with aPTT and the fibrinogen level, MTG with the fibrinogen level, TMG with aPTT, and the TTG with the fibrinogen level. Pearson's correlation coefficient was reported and varied between 0.21 (TMG vs. aPTT) and 0.40 (TTG vs. fibrinogen level).…”

Section: Correlation With Conventional Parameters Of Hemostasismentioning

confidence: 99%

Thromboelastometry and Thrombelastography Analysis under Normal Physiological Conditions - Systematic Review

Adler

Ivic

Bodmer

et al. 2017

Transfus Med Hemother

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Background: Studies investigating thromboelastometry or thrombelastography analyses in a physiological context are scattered and not easy to access. Objective: To systematically retrieve and describe published reports studying healthy subjects and targeting at the correlation of ROTEM® and TEG® measurements with conventional parameters of hemostasis. Methods: Systematic Review: Papers were searched in Medline, Scopus and the Science Citation Index database. Reference lists of included studies and of reviews were screened. To be included papers had to report ROTEM or TEG data on healthy subjects. Two reviewers screened papers for inclusion, read full texts of potentially relevant papers, and extracted data of included papers. Results: Searches identified 1,721 records of which 1,713 were either excluded immediately or after reading the full text. The remaining 8 studies enrolled 632 subjects. The association of conventional parameters of hemostasis with ROTEM and with TEG was investigated in one and two studies, respectively. Overall correlation was limited and ranged from 0.0 to 0.40 (total thrombus generation vs. fibrinogen; clotting time INTEM vs. activated partial thromboplastin time). Conclusions: Studies assessing the relationship between thromboelastometry or thromboelastography analyses and conventional parameters of hemostasis in healthy subjects remains scarce, and correlations are limited. Further research is needed to understand the physiology of thromboelastometry and thromboelastography parameters.

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“…7 These technologies have been used to verify the presence of hypercoagulability in pregnant and postpartum women [8][9][10] and have also been used to detect a positive association between blood hypercoagulability and age in non-obstetric patients. 11,12 Furthermore, previous non-obstetric studies have reported that hypercoagulable states detected by TEG are associated with an increased risk of thrombotic complications, including myocardial infarction and thromboembolic events. [13][14][15] Nevertheless, these technologies have not been used to investigate whether differences exist in the maternal coagulation profile of AMA vs non-AMA women during the peripartum period.…”

Section: Résumémentioning

confidence: 99%

Impact de l’âge maternel avancé sur les profils de coagulation thrombo-élastographique du péripatum: une étude observationnelle prospective exploratoire

Butwick

Gutiérrez

Hilton

2014

Can J Anesth/J Can Anesth

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Purpose Advanced maternal age (AMA) is a known risk factor for pregnancy-related venous thromboembolism. However, it is unclear if underlying differences exist in the maternal coagulation profiles of AMA vs non-AMA women. The aim of this prospective observational study was to compare peripartum thromboelastography parameters of AMA and non-AMA women undergoing elective Cesarean delivery (CD). [25][26][27][28][29][30][31][32][33][34] yr in the AMA and non-AMA groups, respectively (P \ 0.001). We observed no statistically significant effect of study group on any thromboelastographic or laboratory coagulation parameters. No statistically significant correlations were found between any thromboelastographic parameter and maternal age. Peripartum thromboelastography and coagulation profiles of healthy AMA and healthy non-AMA women up to 72 hr post-CD were also similar. Conclusion These data suggest that maternal thromboelastographic profiles of healthy AMA and non-AMA women undergoing elective CD are similar. The study was registered at ClinicalTrials.gov (identifier: NCT01416454). Methods

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In Normal Controls, Both Age and Gender Affect Coagulability as Measured by Thrombelastography

Cited by 90 publications

References 21 publications

Thrombelastography Maximal Clot Strength Could Predict One-Year Functional Outcome in Patients with Ischemic Stroke

Thrombelastography Maximal Clot Strength Could Predict One-Year Functional Outcome in Patients with Ischemic Stroke

Thromboelastometry and Thrombelastography Analysis under Normal Physiological Conditions - Systematic Review

Impact de l’âge maternel avancé sur les profils de coagulation thrombo-élastographique du péripatum: une étude observationnelle prospective exploratoire

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