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. 2025 Aug 27.
doi: 10.1007/s12265-025-10673-4. Online ahead of print.

Platelet Reactivity and Fibrin Clot-Strength as assessed by TEG in Patients with Atrial Fibrillation undergoing Percutaneous Coronary Intervention

Diona Gjermeni  1 , Hannah Vetter  2 , Sofia Szabó  2 , Viktoria Anfang  2 , Carina Juelch  2 , Stefan Leggewie  2 , David Hesselbarth  2 , Markus Jäckel  2 , Daniel Duerschmied  3   4 , Dietmar Trenk  2 , Dirk Westermann  2 , Christoph B Olivier  2
Affiliations

Platelet Reactivity and Fibrin Clot-Strength as assessed by TEG in Patients with Atrial Fibrillation undergoing Percutaneous Coronary Intervention

Diona Gjermeni et al. J Cardiovasc Transl Res. .

Abstract

Platelet reactivity (PR) in clopidogrel-treated patients undergoing percutaneous coronary syndrome (PCI) associates with ischemic and bleeding risk. The aim was to investigate the association of PR and global hemostasis with this risk in patients with atrial fibrillation (AF) undergoing PCI. TEG was performed on day 1-3 after PCI. 168 patients were included. Mean age was 79 years (IQR 72-82). 101 (60%) patients had high platelet reactivity (HPR). HPR was not associated with the composite outcome of MACE (HR 1.23 [ CI 95% 0.43-3.49], p = 0.700). 33(19.6%) patients had HPR and increased platelet-fibrin clot strength and showed a trend for association with higher ischemic risk (HR 2.83 [CI 95% 0.70-8.06], p = 0.078). Rates of HPR in patients with AF undergoing PCI were high. Neither HPR nor LPR predicted ischemic or bleeding risks. Patients with HPR and increased platelet-fibrin clot strength may be at higher risk for ischemic events.

Keywords: Atrial fibrillation; Percutaneous coronary intervention; Platelet aggregation; Thromboelastography.

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Conflict of interest statement

Declarations. Ethics Approval: The protocol and amendments were approved by the local ethics committee (Freiburg,Germany), privacy and security offices, and institutional review board (Ethic protocol number: 21–1146). The study was registered at the German register for clinical trials (DRKS00024509). Consent to Participate: We confirm that all participants involved in this study have provided informed consent to participate. The study was conducted in accordance with ethical guidelines, and participants were made aware of their rights, including the ability to withdraw from the study at any time without penalty. All necessary ethical approvals have been obtained for the use of informed consents and information sheets for study participants in this study. Consent to Publish: We confirm that all study participants have consented to publish the result of the study. We confirm also that all authors of this manuscript have given their consent for the manuscript to be submitted for publication. Additionally, the manuscript has not been submitted elsewhere and is not under consideration for publication by any other journal. Competing interests: CBO reports research support from Haemonetics, Deutsche Forschungsgemeinschaft, Faculty of Medicine, Freiburg University; Else Kröner-Fresenius Stiftung; honoraria: Bayer Vital GmbH, Daiichi Sankyo, Ferrer, Idorsia. DT reports research support by a grant from Deutsche Herzstiftung. He received within the last 24 months consulting fees/payment for lectures including service on speakers’ bureaus by Alexion Pharma, Amgen, AstraZeneca, Atriva, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, Ferrer, Pfizer and Sanofi; DG reports research support by a grant from German Research Foundation; DD received speaker’s honoraria from Daiichi Sankyo, Bayer Healthcare, Boehringer Ingelheim, Pfizer, Sanofi, AOP Health, Boston Scientific, and Novartis, consulting fees from Boston Scientific and Bayer Healthcare, and was supported by the Deutsche Forschungsgemeinschaft (SFB1425 Project #422681845, SFB1366 Project # 394046768), by the Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), and by the Helmholtz-Institute for Translational AngioCardioScience (HI-TAC).

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