Author + information
- Jong-Hwa Ahn,
- Min Gyu Kang,
- Jin-Sin Koh,
- Yongwhi Park,
- Jin-Yong Hwang,
- Jeong Rang Park and
- Young-Hoon Jeong
Background: We evaluate the complementary prognostic value of “Platelet-Fibrin Clot Strength” on post-op CV events compared with anatomy of coronary artery and classic risks.
Methods: PANDA was the prospective study to evaluate prognostic accuracy of CT coronary angiography (CTA) after non-cardiac surgery. “Platelet-Fibrin Clot Strength” measured by thrombelastography (TEG®) was evaluated in 120 patients. The estimating postop risks were classified according to revised cardiac risk index (RCRI), number of significant stenosis (≥ 50% stenosis by CTA), and thrombin-induced maximal amplitude (MAthrombin by TEG). Postop CV events were defined as CV death, MI, stroke and embolism.
Results: Fifteen patients (12.5%) suffered from postop CV events. By the ROC curve analysis, optimal cutoff of TEG®-MAthrombin was ≥ 67 mm (AUC: 0.719; 95% CI: 0.606 to 0.832; p = 0.006). RCRI-adjusted regression analyses showed that “TEG®-MAthrombin ≥ 67 mm” could predict significantly occurrence of CV events (HR: 12.78; 95% CI: 1.58 to 103.49; p = 0.017). When comparing ROC curves of combination models, TEG®-MAthrombin improved risk stratification than RCRI alone (C-statistic: 0.767 vs. 0.634; p = 0.017). Furthermore, combination of TEG®-MAthrombin, CTA and RCRI together showed better discriminative power (C-statistic: 0.828).
Conclusions: Intrinsic hypercoagulability, as well as severity of coronary artery disease in addition to classic risks, increased predictive value on CV events after non-cardiac surgery.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Prognostic Implications of CT Angiography
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1247-237
- 2017 American College of Cardiology Foundation