Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis
Issued Date
2025-01-01
Resource Type
ISSN
03406245
Scopus ID
2-s2.0-85214836218
Journal Title
Thrombosis and Haemostasis
Rights Holder(s)
SCOPUS
Bibliographic Citation
Thrombosis and Haemostasis (2025)
Suggested Citation
Thanapirom K., Suksawatamnuay S., Thaimai P., Ananchuensook P., Kijrattanakul P., Angchaisuksiri P., Tangkijvanich P., Treeprasertsuk S., Komolmit P. Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis. Thrombosis and Haemostasis (2025). doi:10.1055/a-2505-8616 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102865
Title
Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis
Corresponding Author(s)
Other Contributor(s)
Abstract
Background Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year. Methods This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital. The PT- and aPTT-based CWA parameters were obtained using an automated coagulation analyzer. Results A total of 560 patients with cirrhosis were included; 165 (29.5%) and 47 (11.5%) had Child-Turcotte-Pugh (CTP) B and C cirrhosis, respectively. The PT- and aPTT-based CWA parameters, including maximum velocity (min1), maximum acceleration (min2), and maximum deceleration (max2), were significantly lower (p ≤ 0.05) in patients with decompensated cirrhosis than in those with compensated cirrhosis. Additionally, CWA values were significantly higher in patients with higher CTP and Model for End-Stage Liver Disease (MELD) scores. Multivariable analysis revealed that liver stiffness (LS) and max2 of PT-based CWA assay were independently associated with CTP B/C. In addition, min2 and max2 of PT-based CWA assay were independently associated with 1-year mortality. No significant differences in CWA parameters were observed between patients with and without portal vein thrombosis. CWA parameters were not related to AD during the 1-year follow-up. Conclusion A hypocoagulable profile based on CWA parameters is associated with advanced-stage cirrhosis. CWA may be a useful objective marker for assessing cirrhosis severity and predicting 1-year mortality.