Key result
Clot waveform analysis reliably identifies hypercoagulability in acute MI and stroke with ROC AUC >0.90.
Why the study?
Routine APTT and PT measurements do not indicate hypercoagulability in patients with AMI and ACI.
Does clot waveform analysis (CWA-APTT and CWA-sTF/FIXa) effectively detect a hypercoagulable state in patients with acute myocardial infarction and acute cerebral infarction?
Observational (n=587)
No
Does clot waveform analysis (CWA-APTT and CWA-sTF/FIXa) effectively detect a hypercoagulable state in patients with acute myocardial infarction and acute cerebral infarction?
Effect estimate: ROC AUC > 0.900
Absolute Event Rate: 128% vs 64.4%
p-value: p=<0.05
Clot waveform analysis parameters, specifically the AUC/second DPT of CWA-APTT and CWA-sTF/FIXa, are useful markers for detecting hypercoagulability in patients with acute myocardial infarction and acute cerebral infarction.
CWA parameters may aid hypercoagulability detection in AMI and ACI; leaves open validation for clinical risk stratification or therapy guidance.
Background: Routine activated partial thromboplastin time (APTT) and prothrombin time (PT) measurements do not indicate hypercoagulability in patients with acute myocardial infarction (AMI) and acute cerebral infarction (ACI). Methods: Hypercoagulability in patients with AMI or ACI was evaluated using a clot waveform analysis of the APTT or a small amount of tissue factor activation assay (sTF/FIXa). In the CWA, the derivative peak time (DPT), height (DPH), width (DPW), and area the under the curve (AUC) were evaluated. Results: The APTT did not indicate hypercoagulability, but the second DPT of CWA-sTF/FIXa was significantly shorter in patients with ACI than in healthy volunteers (HVs). The first DPH values of CWA-APTT and CWA-sTF/FIXa in patients with ACI and AMI were significantly higher than in HVs. In the receiver operating characteristic (ROC) analyses of ACI or AMI vs. non-thrombosis, the AUC was >0.800 in the DPHs of CWA-APTT and CWA-sTF/FIXa. The AUC of CWA-APTT and CWA-sTF/FIXa in patients with AMI and ACI was significantly higher than in HVs. The AUC/second DPT of CWA-APTT and CWA-sTF/FIXa in patients with AMI and ACI was significantly higher than in HVs. Regarding the ROC analyses of ACI or AMI vs. HVs, the AUC of ROC was higher than 0.800 in the AUC and AUC/second DPT of CWA-APTT and CWA-sTF/FIXa. Conclusions: The AUC/second DPT of CWA-APTT and CWA-sTF/FIXa may be a useful parameter for detecting a hypercoagulable state in patients with AMI and ACI.
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Masuda et al. (2024) conducted an observational in Acute myocardial infarction (AMI) and acute cerebral infarction (ACI) (n=587). Acute myocardial infarction or acute cerebral infarction vs. Healthy volunteers and non-thrombosis patients was evaluated on Hypercoagulability measured by AUC/second derivative peak time (DPT) of CWA-sTF/FIXa (ROC AUC > 0.900, p=<0.05). The AUC/second derivative peak time of CWA-APTT and CWA-sTF/FIXa demonstrated high diagnostic accuracy (ROC AUC >0.900) for detecting a hypercoagulable state in patients with acute myocardial infarction and acute cerebral infarction compared to healthy volunteers.
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