Kreutz, Rolf P.Schmeisser, GlenSchaffter, AndreaKanuri, SriOwens, JanelleMaatman, BenjaminSinha, AnjanLohe, Elisabeth von derBreall, Jeffrey A.2019-08-072019-08-072018-04Kreutz, R. P., Schmeisser, G., Schaffter, A., Kanuri, S., Owens, J., Maatman, B., … Breall, J. A. (2018). Prediction of Ischemic Events after Percutaneous Coronary Intervention: Thrombelastography Profiles and Factor XIIIa Activity. TH open : companion journal to thrombosis and haemostasis, 2(2), e173–e181. doi:10.1055/s-0038-1645876https://hdl.handle.net/1805/20229Background: High plasma fibrin clot strength (MA) measured by thrombelastography (TEG) is associated with increased risk of cardiac events after percutaneous coronary interventions (PCIs). Factor XIIIa (FXIIIa) cross-links soluble fibrin, shortens clot formation time (TEG-K), and increases final clot strength (MA). Methods: We analyzed platelet-poor plasma from patients with previous PCI. Kaolin-activated TEG (R, K, MA) in citrate platelet-poor plasma and FXIIIa were measured (n = 257). Combined primary endpoint was defined as recurrent myocardial infarction (MI) or cardiovascular death (CVD). Relationship of FXIIIa and TEG measurements on cardiac risk was explored. Results: FXIIIa correlated with TEG-MA (p = 0.002) and inversely with TEG-K (p < 0.001). High MA (≥35.35 mm; p = 0.001), low K (<1.15 min; p = 0.038), and elevated FXIIIa (≥83.51%; p = 0.011) were associated with increased risk of CVD or MI. Inclusion of FXIIIa activity and low TEG-K in risk scores did not improve risk prediction as compared with high TEG-MA alone. Conclusion: FXIIIa is associated with higher plasma TEG-MA and low TEG-K. High FXIIIa activity is associated with a modest increase in cardiovascular risk after PCI, but is less sensitive and specific than TEG-MA. Addition of FXIIIa does not provide additional risk stratification beyond risk associated with high fibrin clot strength phenotype measured by TEG.en-USAttribution 3.0 United StatesFactor XIIIFibrinMyocardial infarctionPercutaneous coronary interventionThrombelastographyArticle