Establishment of optimal antithrombotic therapy by using total thrombus-formation analysis system during the perioperative period of transcatheter aortic valve implantation

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K08451
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: University of Miyazaki (2021-2022); Kumamoto University (2020)
• Principal Investigator: Kaikita Koichi 宮崎大学, 医学部, 教授 (30346978)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 血栓形成能 / 経カテーテル的大動脈弁留置 / T-TAS / 無症候性血栓弁

Outline of Final Research Achievements

In this study, we analyzed the relationship between the whole blood thrombogenicity using T-TAS and the subclinical leaflet thrombosis on transcatheter heart valve. Of total 36 patients, 30 treated with only antiplatelet therapy were finally analyzed. subclinical leaflet thrombosis was observed in 20% at 7 days and 21% at 3 months after TAVI, and Maximum leaflet thickness (MLT) was 1.60 mm and 1.65 mm after 7 days and 3 months, respectively. T-TAS parameter, AR10-AUC30, reached the lowest level 7 days after TAVI, and the difference in AR10-AUC30 levels between before and 2 days after TAVI (ΔAR10-AUC30) showed a significant positive correlation with MLT. Univariate linear regression analysis of contributing factors for MLT at 7 days after TAVI revealed that ΔAR10-AUC30 level was the only predictive factor associated with MLT.

Free Research Field

循環器疾患における抗血栓療法に関する研究

Academic Significance and Societal Importance of the Research Achievements

本研究は、TAVI後様々な抗血栓療法が施行されている現状を打破すべく、T-TAS、大動脈造影CT上の無症候性弁血栓およびVWFマルチマー解析等によりTAVI後の血栓形成能の評価と至適抗血栓療法を提案することを目的とした、非常に独自性が高く価値のある臨床研究である。