%0 Journal Article
%T Sonoclot Signature Analysis in Patients with Liver Disease and Its Correlation with Conventional Coagulation Studies
%A Priyanka Saxena
%A Chhagan Bihari
%A Archana Rastogi
%A Savita Agarwal
%A Lovkesh Anand
%A Shiv Kumar Sarin
%J Advances in Hematology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/237351
%X Introduction. Liver disease patients have complex hemostatic defects leading to a delicate, unstable balance between bleeding and thrombosis. Conventional tests such as PT and APTT are unable to depict these defects completely. Aims. This study aimed at analyzing the abnormal effects of liver disease on sonoclot signature by using sonoclot analyzer (which depicts the entire hemostatic pathway) and assessing the correlations between sonoclot variables and conventional coagulation tests. Material and Methods. Clinical and laboratory data from fifty inpatients of four subgroups of liver disease, including decompensated cirrhosis, chronic hepatitis, cirrhosis with HCC and acute-on-chronic liver failure were analyzed. All patients and controls were subjected to sonoclot analysis and correlated with routine coagulation parameters including platelet count, PT, APTT, fibrinogen, and D-dimer. Results. The sonoclot signatures demonstrated statistically significant abnormalities in patients with liver disease as compared to healthy controls. PT and APTT correlated positively with SONACT ( and <0.0015, resp.) while platelet count and fibrinogen levels depicted significant positive and negative correlations with clot rate and SONACT respectively. Conclusion. Sonoclot analysis may prove to be an efficient tool to assess coagulopathies in liver disease patients. Clot rate could emerge as a potential predictor of hypercoagulability in these patients. 1. Introduction Patients with liver disease show significant changes in the hemostatic system. Consequently, routine diagnostic tests such as platelet count, prothrombin time (PT), and activated partial thromboplastin time (APTT) are frequently abnormal. However, interpretation of these tests is much less accurate in patients with complex hemostatic disorders as can be found in patients with liver disease [1]. It is now established that patients with liver disease not only have bleeding tendencies but may develop thrombotic complications as well [2]. The inability of PT-INR and APTT to predict the bleeding risk can be explained by the fact that they incompletely reflect the coagulation process. The parallel decline in the level of natural anticoagulants leading to a prothrombotic tendency is not depicted by these tests. Additionally, significant variations in the INR values have been reported in liver disease patients when tested in different laboratories. Due to this poor reproducibility of INR values, models for end stage liver disease (MELD) score variations up to 12 points have been noted [3]. This could lead to
%U http://www.hindawi.com/journals/ah/2013/237351/