Key result
Elevated thromboelastography maximal amplitude is linked to ~206% greater 1-year MACE risk after off-pump CABG.
Why the study?
Increased thrombogenicity impairs favorable ischemic outcomes in coronary artery disease, but the association between thromboelastography maximal amplitude and 1-year MACE after multi-vessel OPCAB needed investigation.
Does increased maximal amplitude on thromboelastography predict 1-year MACE in patients undergoing isolated multi-vessel off-pump coronary artery bypass surgery?
Cohort (n=657)
No
Does increased maximal amplitude on thromboelastography predict 1-year MACE in patients undergoing isolated multi-vessel off-pump coronary artery bypass surgery?
Elevated maximal amplitude on thromboelastography is linearly associated with an increased risk of 1-year MACE in patients undergoing off-pump coronary artery bypass surgery, suggesting a potential role for TEG screening.
BACKGROUND: Increased thrombogenicity prohibits favorable ischemic outcomes in coronary artery disease. This study investigated the association between increased maximal amplitude (MA) on thromboelastography (TEG), which reflects high platelet-fibrin clot strength, and 1-year major adverse cardiovascular events (MACE) in patients who underwent isolated multi-vessel off-pump coronary artery bypass surgery (OPCAB). PATIENTS AND METHODS: Data from 657 patients were retrospectively analyzed. TEG was performed post-anesthesia induction. MACE was defined as cardiovascular death, repeat revascularization, myocardial infarction, stroke, or rehospitalization due to heart failure. Patients were analyzed by tertiles of MA (mm). Logistic regression analyzed the association between 1-year MACE and MA. RESULTS: tertile). A restricted cubic spline model revealed a linear relationship between MA and 1-year MACE. A 10-mm increase in MA was associated with a two-fold increase in the risk of 1-year MACE. The optimal MA cutoff for predicting MACE was 69.6 (normal range: 50.6-69.4). CONCLUSIONS: Increased thrombogenicity, reflected by elevated MA values, was linearly associated with the occurrence of 1-year MACE, highlighting the need for TEG screening and more aggressive, individualized perioperative anticoagulation management in selected patients with increased MA requiring OPCAB.
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Suh et al. (2025) conducted a cohort in Coronary artery disease requiring off-pump coronary artery bypass surgery (n=657). Elevated maximal amplitude (MA) ≥70.3 mm (3rd tertile) vs. Maximal amplitude (MA) <65.0 mm (1st tertile) was evaluated on 1-year major adverse cardiovascular events (MACE) (OR 3.06, 95% CI 1.27-7.75, p=0.015). Elevated thromboelastography maximal amplitude (≥70.3 mm) was independently associated with an increased risk of 1-year MACE (OR 3.06) after off-pump coronary artery bypass surgery.
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