Evaluation of Coagulation and Fibrinolysis Mechanisms in Deep Vein Thrombosis Using Clot-Fibrinolysis Waveform Analysis.

Abstract

Introduction: Deep vein thrombosis (DVT) is a common condition associated with significant morbidity and mortality. However, the detailed mechanisms of coagulation and fibrinolysis in DVT have not been adequately investigated. Recently, clot-fibrinolysis waveform analysis (CFWA) has been developed to assess coagulation and fibrinolysis reactions as one global assay. This study aimed to investigate the mechanisms of DVT using CFWA.

Methods: DVT diagnosis and definition were conducted by the ultrasonography finding, and the numbers of patients of confirmed DVT and non-DVT were 39 and 56, respectively. Activated partial thromboplastin time-based CFWA was conducted, and the first-derivative curves were analyzed. The curves were separated into two phases: coagulation and fibrinolysis, and the curve shapes were compared between the two groups.

Results: The shapes of first-derivative curves in the coagulation phase for the DVT group were significantly different from those of the non-DVT group, and the curves of the DVT group were sharper and narrower than those of the non-DVT group. Both parameters indicating height and width in the DVT group were significantly lower than the non-DVT group. However, no significant differences were observed in the fibrinolysis phase between two groups.

Conclusion: The DVT group showed different first-derivative curves in the coagulation phase compared to the non-DVT group in the CFWA assay, suggesting that the DVT group had a higher coagulability status. CFWA could be a useful tool for identifying coagulability status in patients with DVT.