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Poster Networking

Arterial Thromboembolism

PB0048 - Procoagulant activity of phospholipids is correlated with thrombin generation parameters: preliminary results from an angiographically-controlled study

Sunday, June 23, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall
Background: Although coagulation plays a crucial role in the pathophysiology of atherothrombosis, the clinical significance of many coagulation biomarkers in ischemic heart disease (IHD) remains controversial so far.

Aims: To assess some global coagulation biomarkers in a single-center, angiographically-controlled, cohort of subjects with or without coronary artery disease (CAD).

Methods: Procoagulant phospholipids (PPL) clotting time, extracellular vesicles-associated tissue factor-dependent (EV-TF) procoagulant activity, and thrombin generation (TG) were assessed in clinically stable subjects undergoing elective coronary angiography.

Results: Data on coagulation biomarkers were available for 297 subjects (males 71.7%; mean age 68.5±9.9 years): 54 subjects had normal coronary arteries (CAD-free group), 50 subjects had coronary lesions with stenosis < 50% (CAD-borderline group), and 193 subjects had coronary lesions with stenosis ≥50% (CAD group). Fifty-two subjects had a history of previous myocardial infarction (MI). Forty-eight subjects taking oral anticoagulant therapies were excluded from further analysis.
There was a strong correlation between PPL clotting time and TG parameters, directly with lag-time and time-to-peak, inversely with endogenous thrombin potential (ETP), peak-thrombin, and mean rate index (MRI), while no correlation was found between EV-TF procoagulant activity and TG parameters, as well as between PPL clotting time and EV-TF procoagulant activity (Figure 1). The association of PPL clotting time with lag-time (beta-coefficient 0.282, P< 0.001), time-to-peak (beta-coefficient 0.152, P=0.018), ETP (beta-coefficient -0.238, P< 0.001), and peak-thrombin (beta-coefficient -0.174, P=0.006) were confirmed after adjustment for sex, age, CAD diagnosis, body mass index, creatinine, PT and aPTT levels.
In a preliminary (but underpowered) case-control analysis, neither PPL clotting time, nor EV-TF procoagulant activity were associated with CAD, CAD severity or history of previous MI, while lag time was longer in patients with CAD and MI.

Conclusion(s): In this pilot study PPL clotting time, but not EV-associated TF-dependent procoagulant activity, correlated with TG parameters in subjects within an angiographically-controlled CAD cohort.