Association of Age on Thromboelastography Coagulation Profiles Among Elderly Patients with Peripheral Arterial Disease.

Abstract

Objective: This study aimed to determine whether age affects thromboelastography (TEG) coagulation profiles among elderly patients with peripheral arterial disease (PAD). We hypothesized that TEG parameters would not significantly differ between age groups when controlled for anticoagulation regimen.

Methods: This was a prospective, single-institution, observational study that included patients aged 65 years and older who underwent open or endovascular lower extremity revascularization for PAD from December 2020 through December 2023. 158 patients were grouped into categories: age 65-74 and age 75+ and anticoagulation regimen (single antiplatelet [50%], dual antiplatelet [15%], therapeutic anticoagulation [27%], none [8%]). Objective TEG coagulation profiles were collected preoperatively and were compared among patient groups. One-way ANOVA analysis was used to compare three or more groups of continuous data, and chi-squared analysis or Fisher's exact test were used to compare categorical data.

Results: Among 158 patients (36.4% female, median age 74.5±6.6 years), there were no significant differences in TEG parameters (reaction time, maximum amplitude, lysis at 30 minutes, angle, ADP% aggregation, ADP% inhibition) between age groups when stratified by anticoagulation regimen (all p>0.05). Thrombosis rates were similar between age groups (21.1% vs. 20.6%, p=0.936), but mortality was significantly higher in the 75+ group (20.6% vs. 5.6%, p=0.005).

Conclusions: Objective coagulation parameters do not appear to vary significantly among age groups within the elderly population when controlled for antiplatelet/anticoagulant regimen. TEG profiles may be used to guide anticoagulation management among elderly patients. Further studies can help elucidate the full utility of TEG profiles for coagulation surveillance among elderly patients.