Thromboelastography-Guided Assessment of Hemostasis in Coronary Heart Disease Patients Undergoing Percutaneous Coronary Intervention

Introduction. Coronary artery disease (CAD) remains one of the leading causes of morbidity and mortality worldwide. Percutaneous coronary intervention (PCI) is a standard revascularization approach; however, post-procedural complications such as thrombosis and bleeding continue to pose clinical challenges. Thromboelastography (TEG) offers a comprehensive assessment of coagulation dynamics, providing real-time insight into clot initiation, formation, strength, and dissolution. Evaluating hemostatic variation in CAD patients undergoing PCI is essential for optimizing antiplatelet and anticoagulant therapy. Aim. This study aimed to assess hemostatic function using TEG in CAD patients undergoing PCI and to analyze differences in coagulation and fibrinolysis profiles across coagulation status groups. Materials and Methods. A prospective cohort study was conducted on CAD patients scheduled for PCI. Whole-blood TEG analysis was performed to obtain R time, K time, alpha angle, maximum amplitude (MA), and LY30 values. Participants were categorized into hypocoagulation, normocoagulation, and hypercoagulation groups based on TEG reference ranges. Statistical analysis was performed with SPSS v25, and p-values ≤0.05 were considered significant. Results and Discussions. The majority of participants were male and aged 55–65 years, consistent with known epidemiological patterns of CAD. Significant differences were found in R time and MA between coagulation groups, with prolonged R time in hypocoagulation and elevated MA in hypercoagulation. K time and alpha angle also differed significantly, reflecting altered clot kinetics across groups. LY30 showed no significant differences, and Chi-square analysis revealed no relationship between coagulation status and fibrinolysis (p=0.288). Hypercoagulation was associated with stronger clot formation, while hypocoagulation reflected delayed coagulation initiation. Conclusions. TEG provides a detailed and individualized assessment of hemostatic function in patients with coronary artery disease undergoing PCI. The observed variability in TEG parameters highlights heterogeneity in post-procedural coagulation profiles across patients. Fibrinolytic activity, as assessed by LY30, appears relatively independent of coagulation status. Further studies incorporating longitudinal follow-up and clinical outcome assessment are required to determine the prognostic and therapeutic implications of TEG-guided evaluation in this population.