Hemostatic Potential Assessment of Patients With Liver Cirrhosis and Atrial Fibrillation by Low-Frequency Piezoelectric Thromboelastography

Abstract

The aim: Our aim was to assess the hemostatic potential of patients with liver cirrhosis and atrial fibrillation by LPTEG global coagulation assay, to investigate changes in LPTEG parameters according to the stage of liver cirrhosis and compare results with liver cirrhosis group. Materials and methods: We performed a prospective cross-sectional study including 70 patients with liver cirrhosis and atrial fibrillation, 36 patients with liver cirrhosis and 20 healthy individuals. LPTEG parameters were measured using ARP-01M “Mednord” in order to assess coagulation abnormalities. Results: t1 and Intensity of contact coagulation didn't differ (p>0,05), Constant of thrombin activity was increased (47.53±0.8vs.34.51±1.88, p<0.001), t3 was reduced (5,0±0.1vs.6.7±0.36 p<0.001), Intensity of coagulation drive was increased (52.8±1.8vs.38.55±1.54, p = 0.001), Intensity of clot polymerization was increased (19.66±0.28vs.16.29±0.28, p<0.001), time t5 was reduced (32.94±0.36 vs. 36.8±1.30, p<0.01), Maximum amplitude was increased (655.7±9.19 vs. 547±19.38, p<0.001), Intensity of total coagulation was increased (19.41±0.34vs.15,09±0.56, p<0.001), Intensity of clot retraction and lysis was increased (4.1±0.07vs.3±0.15, p<0.001) and Coefficient of total anticoagulant activity was increased (2.81±0.05 vs. 2.48 ± 0.06, p<0.001) compared to liver cirrhosis. Conclusions: In patients with liver cirrhosis and atrial fibrillation the hemostatic potential is significantly shifted towards hypercoagulation with a gradual worsening of coagulation disorders, starting from the compensated stage of liver cirrhosis.

Assessment of the efficiency and safety of anticoagulation therapy in patients with liver cirrhosis and atrial fibrillation

“…To analyze the predictive factors for bleeding complications in patients with liver cirrhosis and atrial fibrillation, Cox logistic regression analysis was used. More than 30 anamnestic, clinical, laboratory and instrumental parameters were analyzed, including parameters of low-frequency piezoelectric thromboelastography (LPTEG) – the test of global hemostasis assessment, which was used to investigate hemostasis in patients with LC and AF in previous studies [ 21 ]. Data from 56 patients were included in this study.…”

“…Tests of the global hemostasis assessment, in particular LPTEG, are promising for the diagnosis of coagulopathies in patients with LC, including the ability to simultaneously and quickly evaluate all its stages, and are also useful for monitoring the state of hemostasis in patients treated with anticoagulant drugs. According to the results of our previous study, using this method, we found that patients with LC and AF have a tendency to thrombotic complications and prescription of anticoagulants is potentially beneficial for this population [ 21 ].…”