Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis.

IF 5 2区医学 Q1 HEMATOLOGY

Thrombosis and haemostasis Pub Date : 2025-01-09 DOI:10.1055/a-2505-8616

Kessarin Thanapirom, Sirinporn Suksawatamnuay, Panarat Thaimai, Prooksa Ananchuensook, Pitiphong Kijrattanakul, Pantep Angchaisuksiri, Pisit Tangkijvanich, Sombat Treeprasertsuk, Piyawat Komolmit

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引用次数: 0

Abstract

Background: Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.

Methods: This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital. The PT- and aPTT-based CWA parameters were obtained using an automated coagulation analyzer.

Results: A total of 560 patients with cirrhosis were included; 165 (29.5%) and 47 (11.5%) had Child-Turcotte-Pugh (CTP) B and C cirrhosis, respectively. The PT- and aPTT-based CWA parameters, including maximum velocity (min1), maximum acceleration (min2), and maximum deceleration (max2), were significantly lower (p ≤ 0.05) in patients with decompensated cirrhosis than in those with compensated cirrhosis. Additionally, CWA values were significantly higher in patients with higher CTP and Model for End-Stage Liver Disease (MELD) scores. Multivariable analysis revealed that liver stiffness (LS) and max2 of PT-based CWA assay were independently associated with CTP B/C. In addition, min2 and max2 of PT-based CWA assay were independently associated with 1-year mortality. No significant differences in CWA parameters were observed between patients with and without portal vein thrombosis. CWA parameters were not related to AD during the 1-year follow-up.

Conclusion: A hypocoagulable profile based on CWA parameters is associated with advanced-stage cirrhosis. CWA may be a useful objective marker for assessing cirrhosis severity and predicting 1-year mortality.

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血块波形分析参数与肝硬化严重程度的关系。

背景：血块波形分析（CWA）提供了一个全面的止血评估，可能对合并复杂止血异常的肝硬化患者有用。本研究旨在评估基于凝血酶原时间（PT-）和活化的部分凝血活素时间（aPTT-）的CWA参数与肝硬化严重程度之间的关系，并前瞻性评估CWA在预测1年内死亡率和急性失代偿（AD）中的作用。方法：这项前瞻性研究纳入了2021年6月至2023年12月在朱拉隆功大学医院的成年肝硬化患者。使用自动凝血分析仪获得基于PT和aptt的CWA参数。结果：共纳入肝硬化患者560例；165例（29.5%）和47例（11.5%）分别为child - turcote - pugh (CTP) B型和C型肝硬化。基于PT和aptt的CWA参数，包括最大速度（min1）、最大加速度（min2）和最大减速（max2），失代偿性肝硬化患者明显低于代偿性肝硬化患者（p≤0.05）。此外，CTP和终末期肝病模型（MELD）评分较高的患者的CWA值显著较高。多变量分析显示，肝脏硬度（LS）和max2与CTP B/C独立相关。此外，基于pt的CWA检测的min2和max2与1年死亡率独立相关。有无门静脉血栓患者的CWA参数无明显差异。在1年的随访中，CWA参数与AD无关。结论：基于CWA参数的低凝状态与晚期肝硬化相关。CWA可能是评估肝硬化严重程度和预测1年死亡率的有用客观指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis and haemostasis 医学-外周血管病

CiteScore

11.90

自引率

9.00%

发文量

140

审稿时长

1 months

期刊介绍： Thrombosis and Haemostasis publishes reports on basic, translational and clinical research dedicated to novel results and highest quality in any area of thrombosis and haemostasis, vascular biology and medicine, inflammation and infection, platelet and leukocyte biology, from genetic, molecular & cellular studies, diagnostic, therapeutic & preventative studies to high-level translational and clinical research. The journal provides position and guideline papers, state-of-the-art papers, expert analysis and commentaries, and dedicated theme issues covering recent developments and key topics in the field.