Total Thrombus-Formation Analysis System can Predict 1-Year Bleeding Events in Patients with Coronary Artery Disease.
AIMS
The assessment of bleeding risk in patients with coronary artery disease (CAD) is clinically important. We recently developed the Total Thrombus-Formation Analysis System (T-TAS) for the quantitative analysis of thrombus formation using microchips with thrombogenic surfaces. Here, we assessed the utility of T-TAS parameters in predicting 1-year bleeding events in patients with CAD.


METHODS
The study subjects were 561 consecutive patients who underwent coronary angiography (CAG) between August 2013 and September 2016 for suspected CAD. Blood samples collected at the time of CAG were used for T-TAS to compute the area under the curve (AUC) (AR10-AUC30) in the AR chip. Patients were divided into three groups according to AR10-AUC30 (low: ≤ 1603, intermediate, and high: ＞1765, n=187 each). One-year bleeding events were defined by the Platelet Inhibition and Patient Outcomes criteria.


RESULTS
Bleeding occurred in 21 (3.7%) patients and was classified as major (8 [1.4%]) and minor (13 [2.3%]). The AR10-AUC30 levels were significantly lower in the bleeding group than the non-bleeding group (median [interquartile range] 1590 [1442-1734] vs. 1687 [1546-1797], p=0.04). Univariate Cox regression analysis demonstrated that low AR10-AUC30 , high prothrombin time-international normalized ratio levels, and diabetes correlated with bleeding events. Multivariate Cox regression analysis identified low AR10-AUC30 levels as a significant determinant of bleeding events. Kaplan-Meier survival curves showed a higher rate of bleeding events in the low than the high AR10-AUC30 group (p=0.007).


CONCLUSIONS
The results highlight the potential usefulness of the AR10-AUC30 levels in the prediction of 1-year bleeding events in patients with CAD treated with various antithrombotic therapies.
['Mitsuse|Tatsuro|T|', 'Kaikita|Koichi|K|', 'Ishii|Masanobu|M|', 'Oimatsu|Yu|Y|', 'Nakanishi|Nobuhiro|N|', 'Ito|Miwa|M|', 'Arima|Yuichiro|Y|', 'Sueta|Daisuke|D|', 'Iwashita|Satomi|S|', 'Fujisue|Koichiro|K|', 'Kanazawa|Hisanori|H|', 'Takashio|Seiji|S|', 'Araki|Satoshi|S|', 'Usuku|Hiroki|H|', 'Suzuki|Satoru|S|', 'Sakamoto|Kenji|K|', 'Yamamoto|Eiichiro|E|', 'Soejima|Hirofumi|H|', 'Tsujita|Kenichi|K|']
D000368:Aged D000925:Anticoagulants D019540:Area Under Curve D001780:Blood Coagulation Tests D017023:Coronary Angiography D003324:Coronary Artery Disease D005260:Female D006470:Hemorrhage D006801:Humans D007564:Japan D053208:Kaplan-Meier Estimate D008297:Male D046208:Microchip Analytical Procedures D010975:Platelet Aggregation Inhibitors D011237:Predictive Value of Tests D011379:Prognosis D013927:Thrombosis
Bleeding CAD T-TAS AR10-AUC30 Antithrombotic therapy