Investigation of the Value of Coagulation Parameters in Thromboembolic Events Among Patients Not Receiving Anticoagulant Therapy

Abstract

Objective: The main causes of thromboembolic events are atherosclerosis, vascular endothelial injury, and hypercoagulability. Coagulation is activated through two basic mechanisms, including intrinsic and extrinsic pathways, leading to thrombin production as a result of a series of enzymatic reactions. The intrinsic pathway is evaluated with activated partial thromboplastin time (aPTT) and extrinsic pathway with prothrombin time (PT). This study aimed to investigate the relationship between thromboembolic diseases and coagulation parameters.
 Material and Methods: Patients diagnosed with acute ischemic stroke (AIS) (n=216), acute coronary syndrome (ACS) (n=25), pulmonary thromboembolism (PTE) (n=15), and patients without an emergency pathology (n=71) (Control Group) in the emergency department were retrospectively reviewed in the period from 01 November 2016 to 31 March 2019.
 Results: The aPTT (25.61±5.93 sec), PT (12.05±2.26 sec), and INR (1.04±0.19) values of the AIS group were statistically significantly lower compared to values of the control group (p = ˂0.001, ˂0.001 and ˂0.001 respectively). Similarly, the aPTT (27.15±8.97 sec), PT (12.26±2.75 sec), and INR (1.03±0.25) values of the ACS group were statistically significantly lower compared to those of the control group (p=0.012, 0.030, and 0.001, respectively). There was no statistically significant difference between the PTE group and control group in terms of aPTT, PT, and INR values (p= 0.133, 0.758, and 0.711, respectively).
 Conclusion: Shortened aPTT levels in cases without a history of anticoagulant use at the time of admission can be considered to be a predictive and effective tool for clinicians in arterial embolic events (AIS and ACS).