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血栓弹力描记术与冠心病的相关性。

Association Between Thromboelastography and Coronary Heart Disease.

机构信息

College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China (mainland).

BGI-Shenzhen, Shenzhen, Guangdong, China (mainland).

出版信息

Med Sci Monit. 2022 May 1;28:e935340. doi: 10.12659/MSM.935340.

Abstract

BACKGROUND Thromboelastography (TEG) is a novel blood viscoelasticity detection method revealing blood coagulation status and has been reported to be helpful in predicting clinical outcomes in patients with cardiovascular diseases (CVD). In this study, we aimed to investigate the association between TEG and CVD. MATERIAL AND METHODS A single-center case-control study was performed. Individuals who took TEG tests at Tongji Hospital in Wuhan, China from 2015 to 2019 were included. The nearest-neighbor Mahalanobis matching with replacement, within propensity score calipers of 0.25 was used to control the covariate imbalance between CVD patients and controls. Logistic regression analyses were conducted to assess the relationship between TEG and CVD. Subgroup and sensitivity analyses were performed to evaluate the robustness of the association between TEG and CVD. RESULTS After matching, a total of 151 participants were included in this study, with 83 patients having CVD (49 patients having coronary heart disease [CHD] and 34 patients having an ischemic stroke). By comparison, CHD patients had a significantly higher maximum amplitude (MA) (P=0.02) than controls. After multivariable adjustment, MA (OR 1.11, 95% CI 1.01-1.24, P=0.04) was independently associated with CHD. The association between MA and CHD remained robust across subgroups and in sensitivity analyses. CONCLUSIONS The current study suggests that MA is significantly associated with CHD. Enhanced platelet reactivity as described by high MA might be associated with risk of CHD. The exact role of MA in the measurement of CHD risk needs to be further examined in large-scale prospective cohort studies.

摘要

背景

血栓弹力图(TEG)是一种新型的血液粘弹性检测方法,可反映血液凝血状态,已被报道有助于预测心血管疾病(CVD)患者的临床结局。本研究旨在探讨 TEG 与 CVD 的关系。

材料与方法

采用单中心病例对照研究。纳入 2015 年至 2019 年在中国武汉同济医院进行 TEG 检测的个体。采用最近邻 Mahalanobis 匹配(替换),在倾向评分卡尺为 0.25 时,控制 CVD 患者和对照组之间的协变量不平衡。采用 logistic 回归分析评估 TEG 与 CVD 之间的关系。进行亚组和敏感性分析以评估 TEG 与 CVD 之间关联的稳健性。

结果

匹配后,本研究共纳入 151 名参与者,其中 83 名患者患有 CVD(49 名患有冠心病[CHD],34 名患有缺血性脑卒中)。相比之下,CHD 患者的最大振幅(MA)显著更高(P=0.02)。经过多变量调整后,MA(OR 1.11,95%CI 1.01-1.24,P=0.04)与 CHD 独立相关。MA 与 CHD 之间的关联在亚组和敏感性分析中仍然稳健。

结论

本研究表明 MA 与 CHD 显著相关。高 MA 描述的增强血小板反应性可能与 CHD 风险相关。MA 在 CHD 风险测量中的确切作用需要在大规模前瞻性队列研究中进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a6/9069971/0fe26ff72c6e/medscimonit-28-e935340-g001.jpg

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