title: Total Thrombus-Formation Analysis System (T-TAS) Can Predict Periprocedural Bleeding Events in Patients Undergoing Catheter Ablation for Atrial Fibrillation.
abstract: BACKGROUND
  Non-vitamin K antagonist oral anticoagulants are used to prevent thromboembolism in patients with atrial fibrillation. The T-TAS "Total Thrombus-formation Analysis System" (Fujimori Kogyo Co Ltd) was developed for quantitative analysis of thrombus formation using microchips with thrombogenic surfaces (collagen, platelet chip [PL] ; collagen plus tissue factor, atheroma chip [AR]). We evaluated the utility of T-TAS in predicting periprocedural bleeding in atrial fibrillation patients undergoing catheter ablation (CA).
  
  
  RESULTS
  After exclusion of 20 from 148 consecutive patients undergoing CA, the remaining 128 patients were divided into 2 treatment groups: the warfarin group (n=30) and the non-vitamin K antagonist oral anticoagulants group (n=98). Blood samples obtained on the day of CA (anticoagulant-free point) and at 3 and 30 days after CA were used in T-TAS to compute the thrombus formation area under the curve (AUC; AUC for the first 10 minutes for PL tested at flow rate of 24 μL/min [PL24-AUC10]; AUC for the first 30 minutes for AR tested at flow rate of 10 μL/min [AR10-AUC30]). AR10-AUC30 and PL24-AUC10 levels were similar in the 2 groups on the day of CA. Levels of AR10-AUC30, but not PL24-AUC10, were significantly lower in the 2 groups at days 3 and 30 after CA. Multiple logistic regression analyses identified the AR10-AUC30 level on the day of CA as a significant predictor of periprocedural bleeding events (odds ratio 5.7; 95% CI 1.54-21.1; P=0.009). Receiver operating characteristic analysis showed that the AR10-AUC30 level on the day of CA significantly predicted periprocedural bleeding events (AUC 0.859, 95% CI 0.766-0.951; P<0.001). The cutoff AR10-AUC30 level was 1648 for identification of periprocedural bleeding events.
  
  
  CONCLUSIONS
  These results suggested that the AR10-AUC30 level determined by T-TAS is a potentially useful marker for prediction of bleeding events in atrial fibrillation patients undergoing CA.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Miwa
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Koichi
authors.initials: K
authors.lastname: Kaikita
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sueta
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ishii
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Yu
authors.initials: Y
authors.lastname: Oimatsu
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Arima
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Satomi
authors.initials: S
authors.lastname: Iwashita
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Aya
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hoshiyama
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Hisanori
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakamoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tsujita
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Megumi
authors.initials: M
authors.lastname: Yamamuro
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Sunao
authors.initials: S
authors.lastname: Kojima
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Seiji
authors.initials: S
authors.lastname: Hokimoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Yamabe
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (M.I., K.K., D.S., M.I., Y.O., Y.A., S.I., A.T., T.H., H.K., K.S., E.Y., K.T., M.Y., S.K., S.H., H.Y., H.O.).
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests / Q000295:instrumentation*; D016063:Blood Loss, Surgical; D017115:Catheter Ablation / Q000009:adverse effects*; D016903:Drug Monitoring / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D056656:Lab-On-A-Chip Devices; D008297:Male; D046208:Microchip Analytical Procedures; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: anticoagulants; periprocedural bleeding events; thrombogenicity
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