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Updated: Dec 31, 2025
Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
The thromboelastography G parameter as a potential biomarker of acute coronary syndrome
Qingfen Zhou1, Minjing Mao2, Jun Meng2
1Department of Cardiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Insights
Thromboelastography's shear elastic modulus (G) shows promise as a diagnostic indicator for acute coronary syndrome (ACS). This global hemostasis test effectively measures platelet and fibrinogen activation, aiding in early ACS diagnosis.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Diagnostic Biomarkers
Background:
- Acute coronary syndrome (ACS) diagnosis relies on identifying intra-arterial thrombus formation, often linked to plaque rupture and subsequent platelet/fibrinogen activation.
- Conventional coagulation tests (CCTs) have limitations, assessing only individual coagulation aspects and using platelet-poor plasma, thus missing platelet contributions.
- Thromboelastography (TEG) offers a global assessment of hemostasis using whole blood, encompassing the entire coagulation process from initiation to fibrinolysis.
Purpose of the Study:
- To evaluate thromboelastography (TEG) parameters as potential surrogate biomarkers for thrombus formation in acute coronary syndrome (ACS).
- To assess the diagnostic performance of TEG indices for identifying ACS.
- To determine if TEG parameters can serve as early diagnostic indicators for ACS.
Main Methods:
- Utilized receiver operating characteristic (ROC) curve analysis to evaluate the diagnostic performance of individual TEG indices.
- Employed logistic regression analysis to identify independent risk factors associated with ACS.
- Measured the shear elastic modulus (G) parameter of TEG as a key indicator.
Main Results:
- The shear elastic modulus (G) emerged as an independent diagnostic indicator for ACS, with an odds ratio (OR) of 2.600 (95% CI, 2.035-3.322).
- The area under the ROC curve for G was 0.866, indicating strong diagnostic capability.
- An optimal cut-off value of 10.55 dyne/cm² for G demonstrated a sensitivity of 66.2% and a specificity of 92.4% in diagnosing ACS.
Conclusions:
- The shear elastic modulus (G) is an effective indicator of platelet and fibrinogen activation.
- G demonstrates significant potential as a valuable biomarker for the early diagnosis of acute coronary syndrome (ACS).
- TEG analysis, specifically the G parameter, offers a more comprehensive approach to assessing hemostasis in ACS compared to conventional tests.
Abstract:
The most prominent event that defines acute coronary syndrome (ACS) is the formation of an intra-arterial thrombus, usually resulting from activation of platelet and fibrinogen at the ruptured plaque. Usually, conventional coagulation tests (CCTs) are used to estimate the hemostatic properties of patients. However, CCTs have significant limitations because they each assess individual aspects of the coagulation cascade, which is a complex multifaceted process. And CCTs are performed with platelet-poor plasma, while the contribution of platelets to clot formation is not measured. In contrast, thromboelastography (TEG) is a test for global hemostasis with whole blood, from the beginning of coagulation through clot formation to the ending with fibrinolysis. The aim of this study was to investigate whether TEG parameters could be surrogate biomarkers of thrombus formation process and diagnosis of ACS. Receiver operating characteristic（ROC）curve was used to evaluate the diagnosis performance of each index. Logistic regression analysis was utilized to define the independent risk factors of ACS. The results showed that the shear elastic modulus parameter (G) was an independent diagnostic indicator for ACS (odds ratio [OR], 2.600; 95% confidence interval [CI], 2.035-3.322). The area under ROC curve of G was 0.866. The optimal cut-off value for the diagnosis of ACS was 10.55 dyne/cm2, while the sensitivity was 66.2% and the specificity was 92.4%. In conclusion, G could be used as an optimal indicator of activation of platelet and fibrinogen, which is eligible to be a useful biomarker for early diagnosis of ACS.
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