Hemodialysis-related low thrombogenicity measured by total thrombus-formation analysis system in patients undergoing percutaneous coronary intervention. Issue 200 (April 2021)

• Record Type: Journal Article
• Authors: Nakanishi, Nobuhiro; Kaikita, Koichi; Ishii, Masanobu; Kuyama, Naoto; Tabata, Noriaki; Ito, Miwa; Yamanaga, Kenshi; Fujisue, Koichiro; Hoshiyama, Tadashi; Kanazawa, Hisanori; Hanatani, Shinsuke; Sueta, Daisuke; Takashio, Seiji; Arima, Yuichiro; Araki, Satoshi; Usuku, Hiroki; Nakamura, Taishi; Suzuki, Satoru; Yamamoto, Eiichiro; Soejimaa, Hirofumi; Matsushita, Kenichi; Tsujita, Kenichi
• Is Part Of: Thrombosis research. Issue 200(2021)
• Page Start: 141
• Page End: 148
• Publication Date: 2021-04
• Subjects: ACS acute coronary syndrome -- AF atrial fibrillation -- AR10-AUC30 for atheroma chip, area under the flow pressure curve under constant flow of 10 μL/min across 30 min -- BMI body mass index -- CAD coronary artery disease -- DAPT dual antiplatelet treatment -- DOAC direct oral anticoagulant -- eGFR estimated glomerular filtration rate -- HD hemodialysis -- IHD ischemic heart disease -- MI myocardial infarction -- NSAIDS nonsteroidal anti-inflammatory drugs -- PCI percutaneous coronary intervention -- PL18-AUC10 for platelet chip, area under the flow pressure curve under constant flow of 18 μL/min across 10 min -- PPI proton pomp inhibitor -- T-TAS Total Thrombus-formation Analysis System; AR10-AUC30 -- Bleeding -- HD -- T-TAS -- PL18-AUC10; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2021.02.004
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Background: Established antithrombotic therapies can increase bleeding risk, especially in hemodialysis (HD) patients. The Total Thrombus-formation Analysis System (T-TAS) is useful for evaluating thrombogenicity. The aim of this study was to examine the relationship between HD and thrombogenicity, or bleeding events in patients undergoing percutaneous coronary intervention (PCI). Methods: In this retrospective cohort study, 300 patients undergoing elective PCI were enrolled between April 2017 and March 2019. Blood samples obtained on the day of PCI were analyzed with T-TAS to compute the thrombus formation area under the curve (AUC; PL18 -AUC10 for platelet chip; AR10 -AUC30 for atheroma chip). The patients were divided into three groups according to estimated glomerular filtration rate (eGFR): 33 HD patients, 124 non-HD patients with eGFR <60 mL/min/1.73m 2, and 143 non-HD patients with eGFR ≥60. We examined the thrombogenicity and spontaneous bleeding events within 1-year post-PCI. Results: HD was significantly associated with both low PL18 -AUC10 and AR10 -AUC30 levels determined by T-TAS. Bleeding events defined by the Bleeding Academic Research Consortium criteria types 2, 3, or 5 occurred during follow-up in 27 patients (9.0%): 7 in HD, 10 in non-HD with eGFR <60, and 10 in non-HD with eGFR ≥60. Both T-TAS parameters in the patients with bleeding were lower compared with those in the patients without bleeding, and HD was significantly associated with 1-year bleeding events. Conclusions: The results suggested that HD patients undergoing PCI might be a predictor for low thrombogenicity measured by T-TAS and 1-year bleeding risk. Highlights: Total Thrombus-formation Analysis System (T-TAS) can evaluate the thrombogenicity. We examined the thrombogenicity in patients undergoing PCI. Hemodialysis (HD) was associated with low thrombogenicity measured by T-TAS. It is meaningful to evaluate bleeding risk by T-TAS in HD patients undergoing PCI.