The investigation on the hypercoagulability of hepatocellular carcinoma‐related cerebral infarction with thromboelastography

Author:

Cen Gengyu1,Song Yiting1,Chen Shijian1,Liu Liuyu1,Wang Jun1,Zhang Jian2,Li Jing3,Li Guohui4,Li Haihua5,Liang Hongbin6,Liang Zhijian1ORCID

Affiliation:

1. Department of Neurology The First Affiliated Hospital of Guangxi Medical University Nanning China

2. Department of Neurology The Second Affiliated Hospital of Guangxi Medical University Nanning China

3. Department of Neurology The Affiliated Tumor Hospital of Guangxi Medical University Nanning China

4. Department of Neurology Wuzhou Red Cross Hospital Wuzhou China

5. Department of Neurology Fusui County People's Hospital Chongzuo China

6. Department of Neurology Cenxi People's Hospital Cenxi China

Abstract

AbstractAimTo investigate the hypercoagulability of hepatocellular carcinoma (HCC)‐related cerebral infarction (HCRCI) with thromboelastography (TEG).MethodsA multicenter prospective study was conducted in HCRCI patients, HCC patients without cerebral infarction, and acute cerebral infarction (ACI) patients without HCC between January 2016 and December 2019. TEG parameters and laboratory and clinical data were collected and compared among the three groups. To confirm the independent risk factors of HCRCI, multivariate analyses were conducted. Receiver operating characteristic (ROC) curves were utilized to evaluate the area under the curve (AUC) plotted by each independent risk factor.ResultsThere were 38 patients recruited in the HCRCI group, and 152 patients were recruited to the HCC group and the ACI group. The levels of plasma neutrophil count, D‐dimer, α‐fetoprotein (AFP), carcinoembryonic antigen, and maximum amplitude (MA)—a parameter of TEG—were significantly higher in the HCRCI group than HCC and ACI groups. Multivariate logistic regression analysis showed that increased neutrophile count, D‐dimer, AFP, and MA were independently associated with HCRCI. ROC curve analysis showed first that AUC of MA for HCRCI was .875, which was larger than the other risk factors, and second that the optimal cutoff value for MA was 61.35, with a sensitivity of 89.50% and specificity of 66.40%.ConclusionIt was suggested that TEG disclosed that the pathogenesis of HCRIC is exactly related to the hypercoagulability. And with a cutoff value of MA equaling to 61.35, TEG facilitates clinicians to identify HCC patients at high risk of HCRIC.

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

Behavioral Neuroscience

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