Role of Thromboelastogram in monitoring the activation of the coagulation pathway and assessing the associated risk factors for hypercoagulable state in transfusion dependent thalassemia patients

Shastry, Shamee; Mohan, Ganesh; Prethika, PA; Mundkur, Suneel C; Kurien, Annamma; Ahammad, Javed

doi:10.1016/j.transci.2022.103583

Transfusion and Apheresis Science

2023

DOI: 10.1016/j.transci.2022.103583

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Role of Thromboelastogram in monitoring the activation of the coagulation pathway and assessing the associated risk factors for hypercoagulable state in transfusion dependent thalassemia patients

Shamee Shastry

Ganesh Mohan

PA Prethika

et al.

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2024

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Cited by 2 publications

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Hypercoagulability in hemoglobinopathies: Decoding the thrombotic threat

Bou‐Fakhredin,

Cappellini,

Taher

et al. 2024

American J Hematol

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Beta (β)‐thalassemia and sickle cell disease (SCD) are characterized by a hypercoagulable state, which can significantly influence organ complication and disease severity. While red blood cells (RBCs) and erythroblasts continue to play a central role in the pathogenesis of thrombosis in β‐thalassemia and SCD, additional factors such as free heme, inflammatory vasculopathy, splenectomy, among other factors further contribute to the complexity of thrombotic risk. Thus, understanding the role of the numerous factors driving this hypercoagulable state will enable healthcare practitioners to enhance preventive and treatment strategies and develop novel therapies for the future. We herein describe the pathogenesis of thrombosis in patients with β‐thalassemia and SCD. We also identify common mechanisms underlying the procoagulant profile of hemoglobinopathies translating into thrombotic events. Finally, we review the currently available prevention and clinical management of thrombosis in these patient populations.

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Hypercoagulability in hemoglobinopathies: Decoding the thrombotic threat

Bou‐Fakhredin,

Cappellini,

Taher

et al. 2024

American J Hematol

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Prediction of Unexplained Recurrent Miscarriages Using Thromboelastography

Xu,

Yang,

Guan

et al. 2024

IJWH

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Objective This study investigates the thromboelastography (TEG) changes in patients with unexplained recurrent spontaneous abortion (URSA) to identify effective diagnostic markers for URSA. Methods We retrospectively analyzed 160 URSA patients from the Gynecology Department of the First People’s Hospital of Lianyungang (June 2017 - June 2020) and compared them with 190 healthy, fertile women without adverse pregnancy histories (control group). TEG parameters were assessed using logistic regression, applying stepwise selection for model optimization. Model performance was evaluated using Receiver Operating Characteristic (ROC) curves, determining sensitivity and specificity. The Youden index identified optimal cut points for predictive probabilities. Results Significant differences were observed between the URSA and control groups in coagulation reaction time (R), clot formation time (K), clot formation rate (Angle-α), and maximum clot strength (MA) (P<0.05). Multivariable logistic regression identified R, Angle-α, and MA as independent URSA risk factors. The model demonstrated excellent discrimination (AUC: 0.940; 95% CI: 0.918–0.962). The optimal cut point of predictive probability (Youden index) was P=0.355, yielding a sensitivity of 0.925 and specificity of 0.795. Conclusion URSA patients exhibit a hypercoagulable state even when not pregnant. More research is needed to validate our findings and explore the potential clinical implications of anticoagulants in treating URSA.

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Role of Thromboelastogram in monitoring the activation of the coagulation pathway and assessing the associated risk factors for hypercoagulable state in transfusion dependent thalassemia patients

Cited by 2 publications

References 22 publications

Hypercoagulability in hemoglobinopathies: Decoding the thrombotic threat

Hypercoagulability in hemoglobinopathies: Decoding the thrombotic threat

Prediction of Unexplained Recurrent Miscarriages Using Thromboelastography

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