Hypercoagulability on Thromboelastography Can Predict the Functional Outcomes in Patients with Acute Ischemic Stroke

Area of Science:

• Neurology
• Hematology
• Biomarker Discovery

Background:

• Investigating the link between thromboelastography (TEG) reaction time (R), a marker of hypercoagulability, and patient outcomes after ischemic stroke.
• Assessing the association with hemorrhagic transformation (HT) and early neurological deterioration (END).

Purpose of the Study:

• To determine if a shortened TEG R time (<5 minutes) is associated with adverse outcomes in ischemic stroke patients.
• To evaluate TEG R as a potential biomarker for predicting functional recovery.

Main Methods:

• Enrolled ischemic stroke patients and performed immediate TEG analysis.
• Compared baseline characteristics, HT, END, stroke severity, and etiology based on R time.
• Used logistic regression to analyze the association between R time and functional independence at 3 months (modified Rankin Scale [mRS] 0-2).

Main Results:

• Patients with R <5 minutes showed significantly higher rates of HT (21.0% vs. 8.1%) and END (24.3% vs. 8.6%) compared to those with R ≥5 minutes.
• Shortened R time (<5 minutes) was independently associated with reduced odds of achieving functional independence (OR 0.58; 95% CI 0.34-0.97; P=0.038).
• This association persisted when outcomes were defined as disability-free (mRS 0-1) or analyzed ordinally.

Conclusions:

• Hypercoagulability, indicated by TEG R <5 minutes, is a negative predictor of 3-month functional outcome in ischemic stroke.
• Shortened R time is linked to increased HT, END, and varied stroke etiologies.
• TEG parameters show promise as predictive biomarkers for functional outcomes in ischemic stroke management.