Objective
The purpose of this study was to explore the relationship between platelet concentration
(PLT) (× 109/L) and clot strength measured by thromboelastography maximum amplitude (TEG-MA) in
healthy volunteers without a history of coagulation abnormalities. Secondarily, the
relationship between fibrinogen (mg/dL) and TEG-MA was analyzed.
Design
A prospective study.
Setting
At a university's tertiary-care center.
Measurements and Main Results
Using whole blood, PLT was reduced in the first part, and hematocrit was reduced in
the second part of the study by hemodilution with platelet-rich and -poor plasma.
Thromboelastography (TEG 5000 Haemonetics) was performed to measure clot formation
and strength. Spearman correlation coefficients regression analyses and receiver-operating
characteristics (ROC) were obtained to analyze the relationships among PLT, fibrinogen,
and TEG-MA. Strong correlations were found in univariate analysis between PLT and
TEG-MA (r = 0.88; p < 0.0001) and between Fibrinogen and TEG-MA (r = 0.70; p = 0.003).
A biphasic relationship between PLT and TEG-MA was linear below a PLT 90 × 109/L, followed by a plateau above 100 × 109/L (p = 0.001). A linear relationship between fibrinogen (190-474 mg/dL) and TEG-MA
(53-76 mm) was found (p = 0.0007). The ROC analysis found that PLT = 60 × 109/L was associated with a TEG-MA of 53.0 mm. The product of PLT and fibrinogen concentrations
was more strongly correlated (r = 0.91) to TEG-MA than either PLT (r = 0.86) or fibrinogen
(r = 0.71) alone. A ROC analysis revealed that a TEG-MA of 55 mm was associated with
a PLT × fibrinogen of 16,720.
Conclusion
In healthy patients, a PLT of 60 × 109/L was associated with normal clot strength (TEG-MA ≥53 mm), and there was little
change in clot strength with PLT >90 × 109/L. Although prior analyses described the contributions of platelets and fibrinogen
toward clot strength, they are presented and discussed independently. The data above
described clot strength as an interaction among them. Future analyses and clinical
care should evaluate and recognize the interplay.
Key Words
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Article info
Publication history
Published online: February 19, 2023
Publication stage
In Press Corrected ProofIdentification
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