The Detection of Hypercoagulability in  Patients with Acute Cerebral Infarction  Using a Clot Waveform Analysis

Kamon, Toshitaka; Horie, Shotaro; Inaba, Tomoya; Ito, N.; Shiraki, Katsuya; Ichikawa, Yuhuko; Ezaki, Minoru; Shimpo, Hideto; Shimaoka, Motomu; Nishigaki, Akisato; Shindo, Akihiro; Wada, Hideo

doi:10.1177/10760296231161591

Cited by 5 publications

(7 citation statements)

References 26 publications

(34 reference statements)

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“… 26 Although clot waveform analyses for activated partial thromboplastin time (APTT) and a small amount of TF-induced clotting factor IX activation assay can detect hypercoagulability in ACI patients, routine APTT and prothrombin time cannot detect hypercoagulability. 11 Although plasma D-dimer levels are high in patients with ACI, particularly, cardioembolic ACI, they were low in patients with atherosclerotic or lacunar ACI in this study. Plasma sCLEC-2 levels were extremely high in patients with ACI, particularly, in atherosclerotic and lacuna ACI patients, suggesting that elevation of sCLEC-2 may be useful for diagnosing ACI.…”

Section: Discussioncontrasting

confidence: 57%

“…Most Japanese patients with atherosclerotic ACI are generally treated with argatroban, 8 followed by those with atherosclerotic or lacunar ACI, or those with TIA, who are usually treated with aspirin or other antiplatelet agents, 1 , 7 as platelet activation may play an important role in atherosclerosis resulting in ACI or acute myocardial infarction 10 ; in contrast, patients with cardioembolic ACI should be treated with warfarin or DOACs 9 for a hypercoagulable state. 11 …”

Section: Introductionmentioning

confidence: 99%

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Super Formula for Soluble C-Type Lectin-Like Receptor 2 × D-Dimer in Patients With Acute Cerebral Infarction

Kamon,

Wada,

Horie

et al. 2024

Clin Appl Thromb Hemost

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Acute cerebral infarction (ACI) includes atherosclerotic and cardiogenic ACI and involves a thrombotic state, requiring antithrombotic treatment. However, the thrombotic state in ACI cannot be evaluated using routine hemostatic examinations. Plasma soluble C-type lectin-like receptor 2 (sCLEC-2) and D-dimer levels were measured in patients with ACI. Plasma sCLEC-2 and D-dimer levels were significantly higher in patients with ACI than in those without it. The sCLEC-2 × D-dimer formula was significantly higher in patients with ACI than in those without it. A receiver operating characteristic curve showed a high sensitivity, area under the curve, and odds for diagnosing ACI in the sCLEC-2 × D-dimer formula. Although the sCLEC-2 and D-dimer levels were useful for the differential diagnosis between cardiogenic and atherosclerotic ACI, the sCLEC-2 × D-dimer formula was not useful. sCLEC2 and D-dimer levels are useful for the diagnosis of ACI and the sCLEC2 × D-dimer formula can enhance the diagnostic ability of ACI, and sCLEC2 and D-dimer levels may be useful for differentiating between atherosclerotic and cardioembolic ACI.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Super Formula for Soluble C-Type Lectin-Like Receptor 2 × D-Dimer in Patients With Acute Cerebral Infarction

Kamon,

Wada,

Horie

et al. 2024

Clin Appl Thromb Hemost

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“…Previous studies 51 , 52 reported that an increased first DPH could be a useful predictor of thrombosis. However, the increase of first DPH was not sufficient for diagnosing thrombosis in the present study.…”

Section: Discussionmentioning

confidence: 92%

“…Marked increases in the peak heights of the CWA-APTT and CWA-sTF/FIXa were also reported in patients with ACI. 52 The increase in the peak height of the CWA-APTT and CWA-sTF/FIXa is reported to be caused by a thrombin burst. 53 - 56 Although the mechanism underlying the prolonged clotting time in patients with HCC may involve hepatic dysfunction, the concomitance of both prolonged peak times and increased peak heights cannot be sufficiently understood.…”

Section: Discussionmentioning

confidence: 99%

Detection of a Prethrombotic State in Patients with Hepatocellular Carcinoma, Using a Clot Waveform Analysis

Fukui,

Wada,

Ikeda

et al. 2024

Clin Appl Thromb Hemost

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Background: Although hepatocellular carcinoma (HCC) is frequently associated with thrombosis, it is also associated with liver cirrhosis (LC) which causes hemostatic abnormalities. Therefore, hemostatic abnormalities in patients with HCC were examined using a clot waveform analysis (CWA). Methods: Hemostatic abnormalities in 88 samples from HCC patients, 48 samples from LC patients and 153 samples from patients with chronic liver diseases (CH) were examined using a CWA-activated partial thromboplastin time (APTT) and small amount of tissue factor induced FIX activation (sTF/FIXa) assay. Results: There were no significant differences in the peak time on CWA-APTT among HCC, LC, and CH, and the peak heights of CWA-APTT were significantly higher in HCC and CH than in HVs and LC. The peak heights of the CWA-sTF/FIXa were significantly higher in HCC than in LC. The peak times of the CWA-APTT were significantly longer in stages B, C, and D than in stage A or cases of response. In the receiver operating characteristic (ROC) curve, the fibrin formation height (FFH) of the CWA-APTT and CWA-sTF/FIXa showed the highest diagnostic ability for HCC and LC, respectively. Thrombosis was observed in 13 HCC patients, and arterial thrombosis and portal vein thrombosis were frequently associated with HCC without LC and HCC with LC, respectively. In ROC, the peak time×peak height of the first derivative on the CWA-sTF/FIXa showed the highest diagnostic ability for thrombosis. Conclusion: The CWA-APTT and CWA-sTF/FIXa can increase the evaluability of HCC including the association with LC and thrombotic complications.

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“…Hypercoagulability based on CWA-APTT and sTF/FIXa has been reported in patients with acute cerebral infarction [43] and malignant neoplasms [38], which has led to the establishment of a CWA cutoff value for thrombosis. A CWA cutoff value for major bleeding is being established.…”

Section: Future Prospectives Of Cwamentioning

confidence: 99%

Clot Waveform Analysis for Hemostatic Abnormalities

et al. 2023

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Clot waveform analysis (CWA) observes changes in transparency in a plasma sample based on clotting tests such as activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT). Evidence indicates that not only an abnormal waveform but also peak times and heights in derivative curves of CWA are useful for the evaluation of hemostatic abnormalities. Modified CWA, including the PT with APTT reagent, dilute PT (small amount of tissue factor [TF]-induced clotting factor IX [FIX] activation; sTF/FIXa), and dilute TT, has been proposed to evaluate physiological or pathological hemostasis. We review routine and modified CWA and their clinical applications. In CWA-sTF/FIXa, elevated peak heights indicate hypercoagulability in patients with cancer or thrombosis, whereas prolonged peak times indicate hypocoagulability in several conditions, including clotting factor deficiency and thrombocytopenia. CWA-dilute TT reflects the thrombin burst, whereas clot-fibrinolysis waveform analysis reflects both hemostasis and fibrinolysis. The relevance and usefulness of CWA-APTT and modified CWA should be further investigated in various diseases.

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The Detection of Hypercoagulability in Patients with Acute Cerebral Infarction Using a Clot Waveform Analysis

Cited by 5 publications

References 26 publications

Super Formula for Soluble C-Type Lectin-Like Receptor 2 × D-Dimer in Patients With Acute Cerebral Infarction

Super Formula for Soluble C-Type Lectin-Like Receptor 2 × D-Dimer in Patients With Acute Cerebral Infarction

Detection of a Prethrombotic State in Patients with Hepatocellular Carcinoma, Using a Clot Waveform Analysis

Clot Waveform Analysis for Hemostatic Abnormalities

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