Application of thromboelastography for evaluating coagulation and platelet function in patients of acute coronary syndrome complicated with human immunodeficiency virus infection

doi:10.3877/cma.j.issn.1674-1358.2018.05.005

Abstract

Abstract:

Objective

To evaluate the coagulation and platelet function in patients of acute coronary syndrome (ACS) complicated with HIV infection by thromboelastography.

Methods

From April 2015 to February 2018, a total of 32 patients of ACS complicated with HIV infection in Beijing Ditan Hospital, Capital Medical University were selected as observation group, while ACS patients with HIV negative were selected as the control group (32 cases). Thromboelastography, routine coagulation and platelet were taken to detect the coagulation and platelet function. The coagulation and platelet function indexes of the two groups were compared, including reaction time (R), coagulation time (K), coagulation angle (αangle), the maximal amplitude (MA), aspirin and clopidogrel resistance rate, the routine coagulation index and platelet count.

Results

There was no significant difference in average age, hypertension, diabetes, hyperlipidemia, smoking and family history between the two groups (allP> 0.05). R, K were significantly lower in ACS patients with HIV infection than those of single ACS group (t =-4.00, 2.15;P < 0.01,P= 0.03);αangle was significantly higher of patients with ACS and HIV infection than that of single ACS group (t= 2.15,P= 0.03). But there was no significant difference in MA, ADP inhibiting rate and AA inhibiting rate between the two groups (allP> 0.05). There were no significant difference of the levels of PT, APPT, fibrinogen and platelet count of patients in ACS with HIV group than those of single ACS group (all P> 0.05). The reaction time was linearly correlated with APTT (r = 0.39,P = 0.04). The maximal amplitude was linearly related to the platelet count (r= 0.47,P= 0.01) and the content of fibrinogen of the patients (r= 0.68,P< 0.01).

Conclusions

Routine monitoring of thromboelastography in patients with HIV infection and acute coronary syndrome may provide more information on coagulation and platelet function. Patients with ACS and HIV infection are in hypercoagulable state, but adjustment of the antiplatelet therapy regimen due to the condition of HIV is not necessary.

Key words: Acute coronary syndrome, Human immunodeficiency virus, Thrombelastography, Coagulation

Sujuan Zhang, Yuqing Song, Nan Wang, Qian Wang, Ming Wei, Qian Dong, Qiming Wu, Wei Zhang. Application of thromboelastography for evaluating coagulation and platelet function in patients of acute coronary syndrome complicated with human immunodeficiency virus infection[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(05): 440-445.

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References 24

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组别	例数	年龄(±s，岁)	高血压[例(%)]	糖尿病[例(%)]	高脂血症[例(%)]	吸烟史[例(%)]	家族史[例(%)]
HIV阳性ACS组	32	57 ± 9.6	14(43.8)	8(25.0)	27(84.3)	24(75.0)	2(6.3)
HIV阴性ACS组	32	57 ± 9.2	19(59.4)	13(40.6)	26(81.4)	26(81.3)	3(9.4)
统计量	?	t =－0.01	χ² = 1.56	χ² = 1.77	χ² = 0.11	χ² = 0.36	χ² = 0.00
P值	?	0.98	0.21	0.18	0.74	0.54	1.00

组别	例数	年龄(±s，岁)	高血压[例(%)]	糖尿病[例(%)]	高脂血症[例(%)]	吸烟史[例(%)]	家族史[例(%)]
HIV阳性ACS组	32	57 ± 9.6	14(43.8)	8(25.0)	27(84.3)	24(75.0)	2(6.3)
HIV阴性ACS组	32	57 ± 9.2	19(59.4)	13(40.6)	26(81.4)	26(81.3)	3(9.4)
统计量	?	t =－0.01	χ² = 1.56	χ² = 1.77	χ² = 0.11	χ² = 0.36	χ² = 0.00
P值	?	0.98	0.21	0.18	0.74	0.54	1.00

组别	例数	R值(±s)	MA值(±s)	K值(±s)	α角(±s)
HIV阳性ACS组	32	6.83 ± 2.24	61.85 ± 4.98	2.30 ± 0.94	60.92 ± 11.76
HIV阴性ACS组	32	10.06 ± 2.64	60.34 ± 12.87	3.00 ± 1.29	53.13 ± 11.42
统计量	?	t =－4.00	t = 0.56	t = 2.15	t = 2.35
P值	?	< 0.01	0.57	0.03	0.02
组别	例数	AA抑制率(±s，%)	ADP抑制率±s，%)	CR [例(%)]
HIV阳性ACS组	32	72.29 ± 15.31	47.16 ± 24.12	9(29.6)
HIV阴性ACS组	32	67.77 ± 31.23	31.89 ± 31.46	16(50.0)
统计量	?	t = 0.58	t = 2.00	χ² = 3.21
P值	?	0.56	0.05	0.07

组别	例数	R值(±s)	MA值(±s)	K值(±s)	α角(±s)
HIV阳性ACS组	32	6.83 ± 2.24	61.85 ± 4.98	2.30 ± 0.94	60.92 ± 11.76
HIV阴性ACS组	32	10.06 ± 2.64	60.34 ± 12.87	3.00 ± 1.29	53.13 ± 11.42
统计量	?	t =－4.00	t = 0.56	t = 2.15	t = 2.35
P值	?	< 0.01	0.57	0.03	0.02
组别	例数	AA抑制率(±s，%)	ADP抑制率±s，%)	CR [例(%)]
HIV阳性ACS组	32	72.29 ± 15.31	47.16 ± 24.12	9(29.6)
HIV阴性ACS组	32	67.77 ± 31.23	31.89 ± 31.46	16(50.0)
统计量	?	t = 0.58	t = 2.00	χ² = 3.21
P值	?	0.56	0.05	0.07

组别	例数	PT	APTT	FIB	INR	PLT
HIV阳性ACS组	32	11.33 ± 1.39	29.31 ± 3.78	297.38 ± 75.74	1.02 ± 0.12	193.85 ± 49.03
HIV阴性ACS组	32	11.33 ± 0.70	29.08 ± 4.77	314.05 ± 169.17	1.01 ± 0.16	207.81 ± 57.72
t值	?	－0.01	0.19	0.64	0.46	－0.95
P值	?	0.98	0.84	0.52	0.64	0.34

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