Total Thrombus-Formation Analysis System can Predict 1-Year Bleeding Events in Patients with Coronary Artery Disease

J Atheroscler Thromb. 2020 Mar 1;27(3):215-225. doi: 10.5551/jat.49700. Epub 2019 Aug 8.


Aims: The assessment of bleeding risk in patients with coronary artery disease (CAD) is clinically important. We recently developed the Total Thrombus-Formation Analysis System (T-TAS) for the quantitative analysis of thrombus formation using microchips with thrombogenic surfaces. Here, we assessed the utility of T-TAS parameters in predicting 1-year bleeding events in patients with CAD.

Methods: The study subjects were 561 consecutive patients who underwent coronary angiography (CAG) between August 2013 and September 2016 for suspected CAD. Blood samples collected at the time of CAG were used for T-TAS to compute the area under the curve (AUC) (AR10-AUC30) in the AR chip. Patients were divided into three groups according to AR10-AUC30 (low: ≤ 1603, intermediate, and high: >1765, n=187 each). One-year bleeding events were defined by the Platelet Inhibition and Patient Outcomes criteria.

Results: Bleeding occurred in 21 (3.7%) patients and was classified as major (8 [1.4%]) and minor (13 [2.3%]). The AR10-AUC30 levels were significantly lower in the bleeding group than the non-bleeding group (median [interquartile range] 1590 [1442-1734] vs. 1687 [1546-1797], p=0.04). Univariate Cox regression analysis demonstrated that low AR10-AUC30 , high prothrombin time-international normalized ratio levels, and diabetes correlated with bleeding events. Multivariate Cox regression analysis identified low AR10-AUC30 levels as a significant determinant of bleeding events. Kaplan-Meier survival curves showed a higher rate of bleeding events in the low than the high AR10-AUC30 group (p=0.007).

Conclusions: The results highlight the potential usefulness of the AR10-AUC30 levels in the prediction of 1-year bleeding events in patients with CAD treated with various antithrombotic therapies.

Keywords: AR10-AUC30; Antithrombotic therapy; Bleeding; CAD; T-TAS.

MeSH terms

  • Aged
  • Anticoagulants / adverse effects
  • Anticoagulants / classification
  • Anticoagulants / therapeutic use
  • Area Under Curve
  • Blood Coagulation Tests* / methods
  • Blood Coagulation Tests* / statistics & numerical data
  • Coronary Angiography / methods
  • Coronary Angiography / statistics & numerical data
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / drug therapy
  • Coronary Artery Disease* / physiopathology
  • Female
  • Hemorrhage* / chemically induced
  • Hemorrhage* / diagnosis
  • Hemorrhage* / prevention & control
  • Humans
  • Japan
  • Kaplan-Meier Estimate
  • Male
  • Microchip Analytical Procedures / methods
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / classification
  • Platelet Aggregation Inhibitors / therapeutic use
  • Predictive Value of Tests
  • Prognosis
  • Thrombosis* / blood
  • Thrombosis* / diagnosis
  • Thrombosis* / etiology
  • Thrombosis* / prevention & control


  • Anticoagulants
  • Platelet Aggregation Inhibitors