Adriana A. Rodriguez Alvarez MD, Isabella Ferlini Cieri MD, Katherine L. Morrow MD, Mounika Naidu Boya MBBS, Sasha P. Suarez Ferreira MD, Shiv S. Patel BA, Anahita Dua MD, MS, MBA, FACS
{"title":"年龄与老年外周动脉疾病患者血栓弹性成像凝血特征的关系","authors":"Adriana A. Rodriguez Alvarez MD, Isabella Ferlini Cieri MD, Katherine L. Morrow MD, Mounika Naidu Boya MBBS, Sasha P. Suarez Ferreira MD, Shiv S. Patel BA, Anahita Dua MD, MS, MBA, FACS","doi":"10.1016/j.jvs.2025.02.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine whether age affects thromboelastography (TEG) coagulation profiles among elderly patients with peripheral arterial disease. We hypothesized that TEG parameters would not significantly differ between age groups when controlled for anticoagulation regimen.</div></div><div><h3>Methods</h3><div>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 peripheral arterial disease from December 2020 through December 2023. A total of 158 patients were grouped into categories: by age (65 to 74 years and 75+ years) 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 analysis of variance was used to compare three or more groups of continuous data, and χ<sup>2</sup> analysis or Fisher exact test were used to compare categorical data.</div></div><div><h3>Results</h3><div>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, adenosine diphosphate % aggregation, adenosine diphosphate % inhibition) between age groups when stratified by anticoagulation regimen (all <em>P</em> > .05). Thrombosis rates were similar between age groups (21.1% vs 20.6%; <em>P</em> = .936), but mortality was significantly higher in the 75+ group (20.6% vs 5.6%; <em>P</em> = .005).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 1","pages":"Pages 173-179"},"PeriodicalIF":3.6000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of age on thromboelastography coagulation profiles among elderly patients with peripheral arterial disease\",\"authors\":\"Adriana A. Rodriguez Alvarez MD, Isabella Ferlini Cieri MD, Katherine L. Morrow MD, Mounika Naidu Boya MBBS, Sasha P. Suarez Ferreira MD, Shiv S. Patel BA, Anahita Dua MD, MS, MBA, FACS\",\"doi\":\"10.1016/j.jvs.2025.02.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>This study aimed to determine whether age affects thromboelastography (TEG) coagulation profiles among elderly patients with peripheral arterial disease. We hypothesized that TEG parameters would not significantly differ between age groups when controlled for anticoagulation regimen.</div></div><div><h3>Methods</h3><div>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 peripheral arterial disease from December 2020 through December 2023. A total of 158 patients were grouped into categories: by age (65 to 74 years and 75+ years) 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 analysis of variance was used to compare three or more groups of continuous data, and χ<sup>2</sup> analysis or Fisher exact test were used to compare categorical data.</div></div><div><h3>Results</h3><div>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, adenosine diphosphate % aggregation, adenosine diphosphate % inhibition) between age groups when stratified by anticoagulation regimen (all <em>P</em> > .05). Thrombosis rates were similar between age groups (21.1% vs 20.6%; <em>P</em> = .936), but mortality was significantly higher in the 75+ group (20.6% vs 5.6%; <em>P</em> = .005).</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":17475,\"journal\":{\"name\":\"Journal of Vascular Surgery\",\"volume\":\"82 1\",\"pages\":\"Pages 173-179\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Vascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0741521425002964\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0741521425002964","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Association of age on thromboelastography coagulation profiles among elderly patients with peripheral arterial disease
Objective
This study aimed to determine whether age affects thromboelastography (TEG) coagulation profiles among elderly patients with peripheral arterial disease. 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 peripheral arterial disease from December 2020 through December 2023. A total of 158 patients were grouped into categories: by age (65 to 74 years and 75+ years) 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 analysis of variance was used to compare three or more groups of continuous data, and χ2 analysis or Fisher 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, adenosine diphosphate % aggregation, adenosine diphosphate % inhibition) between age groups when stratified by anticoagulation regimen (all P > .05). Thrombosis rates were similar between age groups (21.1% vs 20.6%; P = .936), but mortality was significantly higher in the 75+ group (20.6% vs 5.6%; P = .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.
期刊介绍：
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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