Coronary disease & ACS

Diabetic Status and Thrombogenicity: Association and Prognostic Implications After Percutaneous Coronary Intervention

JACC Cardiovasc IntervPublished Prospective registry cohort study

Authors' conclusion

In percutaneous coronary intervention-treated patients, diabetic status and clot-strength value were significantly correlated. High clot-strength phenotype increased the risk for MACE, irrespective of diabetic phenotype.

Study context

Population
Patients with CAD undergoing PCI, with on-admission glycated hemoglobin and thromboelastography thrombogenicity indexes
Participants
2,501 patients
Exposure
Diabetes mellitus (DM) vs no DM
  • DMn = 970
Outcome
MACE:
  • All-cause death
  • MI
  • Stroke
Follow-up
4-year follow-up

Main finding

As reported in the abstract

Thrombogenicity (thromboelastography)
GroupPlatelet-fibrin clot strength (PFCS), maximal amplitude, median [Q1-Q3]Lysis at 30 min, median [Q1-Q3]
DM67.1 [62.2-72.2] mm0.1% [0.0%-1.0%]
No DM65.5 [61.0-70.4] mm0.2% [0.0%-1.3%]

Platelet-fibrin clot strength (PFCS), maximal amplitude, median [Q1-Q3]

DM67.1 [62.2-72.2] mm
No DM65.5 [61.0-70.4] mm

Lysis at 30 min, median [Q1-Q3]

DM0.1% [0.0%-1.0%]
No DM0.2% [0.0%-1.3%]
  • DM vs No DM: P < 0.001 — PFCS (maximal amplitude)
  • DM vs No DM: P = 0.003 — lysis at 30 min

Observational data: associations, not effects.

Further findings

Major adverse cardiovascular events (MACE) (multivariable analysis) · 4-year follow-up

HR (95% CI)P value
DM phenotypeIndependently associated with MACE1.38 (1.05–1.79)P = 0.018
Diabetic phenotype and high PFCSAdditive effect on MACE2.49 (1.77–3.51)P < 0.001

PFCS vs glycated hemoglobin

Positive relationship with glycated hemoglobin up to 7.0%, then plateau

Original publication

Diabetic Status and Thrombogenicity: Association and Prognostic Implications After Percutaneous Coronary Intervention. JACC Cardiovasc Interv. Published 24 March 2025. doi:10.1016/j.jcin.2024.12.002

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