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The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease.

Publication ,  Journal Article
Bae, JS; Ahn, J-H; Jang, JY; Cho, SY; Kang, MG; Kim, K-H; Park, HW; Koh, J-S; Park, Y; Hwang, S-J; Kwak, CH; Hwang, J-Y; Tantry, US ...
Published in: J Thromb Thrombolysis
November 2020

Patients with peripheral artery disease (PAD) have shown the increased risk of cardiovascular (CV) morbidity and mortality. This study sought to evaluate the impact of clot strength on prevalence and major adverse CV events (MACE) of PAD in high-risk patients. We enrolled patients undergoing percutaneous coronary intervention (PCI) (n = 1667) with available platelet-fibrin clot strength [thrombin-induced maximal amplitude (MAthrombin) measured by thromboelastography] and inflammation [high sensitivity C-reactive protein (hs-CRP)]. PAD was defined with abnormal ankle-brachial index (≤ 0.9 or > 1.4). MACE was defined as a composite of CV death, myocardial infarction or stroke. PAD was observed in 201 patients (12.1%). In the multivariate analysis, high clot strength [MAthrombin ≥ 68 mm: odds ratio (OR) 1.70, 95% confidence interval (CI) 1.20 to 2.41, p = 0.003] and enhanced inflammation (hs-CRP ≥ 3.0 mg/L: OR 2.30, 95% CI 1.56 to 3.41, p < 0.001) were associated with PAD occurrence. During the follow-up post-PCI (median, 25 months), MACE was more frequently occurred in patients with vs. without PAD (18.7% vs. 6.4% at 3 years; hazard ratio 1.72, 95% CI 1.03 to 2.87, p = 0.039). Furthermore, combined presence of PAD and high clot strength significantly increased the risk of MACE. In conclusion, this study is the first to show the impact of clot strength on prevalence and clinical outcomes of PAD in coronary artery disease patients undergoing PCI. Whether antithrombotic strategy according to level of this biomarker can improve clinical outcomes in PAD patients deserves the further study.

Duke Scholars

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

November 2020

Volume

50

Issue

4

Start / End Page

969 / 981

Location

Netherlands

Related Subject Headings

  • Thrombosis
  • Thrombelastography
  • Severity of Illness Index
  • Risk Assessment
  • Republic of Korea
  • Prevalence
  • Postoperative Complications
  • Peripheral Arterial Disease
  • Percutaneous Coronary Intervention
  • Middle Aged
 

Citation

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Bae, J. S., Ahn, J.-H., Jang, J. Y., Cho, S. Y., Kang, M. G., Kim, K.-H., … Jeong, Y.-H. (2020). The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease. J Thromb Thrombolysis, 50(4), 969–981. https://doi.org/10.1007/s11239-020-02103-w
Bae, Jae Seok, Jong-Hwa Ahn, Jeong Yoon Jang, Sang Young Cho, Min Gyu Kang, Kye-Hwan Kim, Hyun Woong Park, et al. “The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease.J Thromb Thrombolysis 50, no. 4 (November 2020): 969–81. https://doi.org/10.1007/s11239-020-02103-w.
Bae, Jae Seok, et al. “The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease.J Thromb Thrombolysis, vol. 50, no. 4, Nov. 2020, pp. 969–81. Pubmed, doi:10.1007/s11239-020-02103-w.
Bae JS, Ahn J-H, Jang JY, Cho SY, Kang MG, Kim K-H, Park HW, Koh J-S, Park Y, Hwang S-J, Kwak CH, Hwang J-Y, Tantry US, Gurbel PA, Jeong Y-H. The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease. J Thromb Thrombolysis. 2020 Nov;50(4):969–981.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

November 2020

Volume

50

Issue

4

Start / End Page

969 / 981

Location

Netherlands

Related Subject Headings

  • Thrombosis
  • Thrombelastography
  • Severity of Illness Index
  • Risk Assessment
  • Republic of Korea
  • Prevalence
  • Postoperative Complications
  • Peripheral Arterial Disease
  • Percutaneous Coronary Intervention
  • Middle Aged