Value of thromboelastography combined with anticoagulant detection in patients over 60 years of age with cardiovascular or cerebrovascular disease.

BACKGROUND: Cardiovascular disease (CVD) and cerebrovascular disease (CBVD) are common diseases in middle-aged and elderly people with high morbidity, mortality and disability rates. Individualized assessment and treatment are helpful to improve the quality of life and prognosis of patients. Thrombelastography (TEG) is a method to evaluate the coagulation function of patient with whole blood. In this study, we investigated the correlation between TEG indicators and traditional indicators of coagulation, and evaluated the diagnostic value of TEG combined with indicators of coagulation in elderly patients with CVD and CBVD. METHODS: We retrospectively analyzed the thrombelastographic indices and traditional indicators of coagulation in 285 cases of elderly patients with CBVD or CVD. All measures were performed by the Department of Clinical Laboratory in the Second Hospital of Jilin University between January 2016 and December 2018. RESULTS: Compared with the control group, the platelet count, mean platelet volume (MPV), and APTT were increased in the CBVD group. K value, MPV, and the MPV/PLT ratio were higher, but fibrinogen levels and the PT were lower in the CVD group than in the control group. In the CVD and CBVD groups, the R value was positively correlated with APTT, the K value was negatively correlated with fibrinogen, α angle was positively correlated with fibrinogen, and the MA was positively correlated with the platelet count and fibrinogen, but negatively correlated with MPV/PLT. The FDP was significantly higher, whereas the D-dimer/FDP ratio was lower in the CBVD group than in the CVD group. CONCLUSIONS: The combined detection of TEG and traditional indicators is more effective than detection using only routine indices in the assessment of the coagulation status of elderly patients with CVD or CBVD. The MPV/PLT and D-dimer/FDP ratios can be used as indices of anticoagulant function.

The significance of coagulation and fibrinolysis-related parameters in predicting postoperative venous thrombosis in patients with breast cancer.

BACKGROUND: To explore the expression level of coagulation and fibrinolysis-related indexes in the plasma of breast cancer patients after surgery, and explore their predictive value for deep venous thrombosis (DVT). METHODS: From May 2016 to May 2019, 63 patients with lower extremity DVT after radical mastectomy in our hospital were selected as the thrombus group, and 69 patients without venous thrombosis after radical mastectomy were selected as the control group. The levels of D-dimer (D-D) and fibrinolytic product (FDP) were measured by latex enhanced immunoturbidimetry, Fibrinogen (FIB) levels were measured using the von Clauss method, thrombin antithrombin complex (TAT) and thrombomodulin (TM) levels were measured by enzyme-linked immunosorbent assay (ELISA), and the evaluation value of coagulation markers on tumor thrombosis was analyzed by receiver operating characteristic curve (ROC) curve analysis. RESULTS: There were significant differences in blood pressure, platelet count (PLT) level, diabetes history, and tumor metastasis between the two groups (P<0.05). The levels of PT, D-D, FDP, TAT, and TM in the thrombus group were significantly higher than those in control group (P<0.05). The area under the curve (AUC) of D-D, FDP, and TAT were 0.790, 0.881, and 0.672, respectively and there was a marked difference among the indexes (P<0.05). The AUC of FDP was the largest, and the sensitivity and diagnostic value of FDP were the highest. CONCLUSIONS: The plasma levels of FDP, D-D, TAT, and TM in breast cancer patients with DVT after radical mastectomy were significantly increased, which is related to imbalanced coagulation and fibrinolysis functioning in patients. FDP had the highest predictive value for DVT after radical mastectomy.