Assessment of preoperative hypercoagulability in patients with pancreatic ductal adenocarcinoma (PDAC) using rapid thromboelastography (r-TEG)

• Published in: Journal of thrombosis and thrombolysis 2019-11, Vol.48 (4), p.648-652
• Main Authors: Mou, Yu, Li, Mao, Hou, Shengzhong, Ren, Xue, Tian, Bole
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma - blood; Cardiology; Case-Control Studies; Coagulation; Female; Health risk assessment; Hematology; Humans; Incidence; Male; Medicine; Medicine & Public Health; Middle Aged; Pancreas; Pancreatic cancer; Pancreatic Neoplasms; Pancreatic Neoplasms - blood; Pancreatic Neoplasms - complications; Preoperative Period; Retrospective Studies; Thrombelastography - methods; Thromboembolism; Thrombophilia - diagnosis; Tumors; Venous Thromboembolism
• ISSN: 0929-5305; 1573-742X
• DOI: 10.1007/s11239-019-01908-8

Patients with malignant tumors are usually accompanied with hypercoagulability state and high incidence risk of venous thromboembolism (VTE), especially in patients with pancreatic ductal adenocarcinoma (PDAC). However, conventional coagulation test is failed to identify this abnormity. We retrospectively reviewed clinical data of 78 PDAC patients and 79 age-matched controls with rapid thromboelastography (r-TEG) and conventional coagulation test. The main index of r-TEG include TEG-ACT (second), R (second), K (second), angleα (°) and MA (mm), and a short TEG-ACT, short R, a short K, a broad angleα and a prolonged MA can identify hypercoagulability. Compared with age-matched controls, the PADC patients were analyzed to have a shorter K value (72. + 24 ± 22.90 vs. 85.63 ± 32.81, P = 0.0014), increased angleα value (76.20 ± 3.68 vs. 74.415 ± 4.73, P = 0.009) and MA value (63.33 ± 7.19 vs. 60.89 ± 5.52, P = 0.18). Both TEG-ACT (101.72 ± 7.57 vs. 103.78 ± 7.33, P = 0.086) and R (32.95 ± 4.72 vs. 34.34 ± 4.61, P = 0.085) value showed no significant difference in two groups. The laboratory values for conventional coagulation test were within normal ranges: PT (11.65 ± 0.95 vs. 11.38 ± 0.79, P = 0.049), INR (1.01 ± 0.09 vs. 0.98 ± 0.08, P = 0.101), aPTT (28.75 ± 3.45 vs. 28.00 ± 2.98, P = 0.149) and TT (19.44 ± 1.12 vs. 19.69 ± 1.35, P = 0.212). Incidence rates of VTE were 3.8% (3 of 78 patients) and 1.3% (1 of 79 patients) respectively (Fisher’s exact test: P = 0.367). Several r-TEG indexes can indicate coagulation disorders within PDAC patients, but the incidence rates of VTE for both PDAC patients and normal controls had no significant difference. Compare to the control group, the potential hypercoagulability of PDAC patients did not correlate to thrombotic complications.