Clinica Chimica Acta 520 (2021) 208–213

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Clinica Chimica Acta

journal homepage: www.elsevier.com/locate/cca

Comparison between thromboelastography and conventional coagulation

assays in patients with deep vein thrombosis
Chaoqin Mao a, 1, Yueshan Xiong b, 1, Cheng Fan c, *
a
Department of Rehabilitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
b
Department of Mathematics, School of Mathematics and Statistics, Huazhong University of Science and Technology, Wuhan 430074, China
c
Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

A R T I C L E I N F O A B S T R A C T

Keywords: Background: Conventional coagulation assays (CCAs) are of limited value in the assessment of coagulation status
Deep vein thrombosis in patients with deep vein thrombosis (DVT). We aimed to compare thromboelastography (TEG) and CCAs in
Thromboelastography identifying DVT and evaluating coagulation status in DVT patients.
Conventional coagulation assay
Methods: Sixty-six patients diagnosed with DVT and forty healthy controls were enrolled. Blood samples were
Hypercoagulability
collected within 4 h of patients’ admission to hospital before any operation and tested by TEG and CCAs. TEG
and CCA parameters were compared between DVT patients and controls. The ability of each parameter in
identifying DVT was assessed. Pearson’s correlation was used to determine the correlation between TEG and CCA
parameters among the study population.
Results: TEG showed significant differences between DVT patients and controls, indicating a hypercoagulable
tendency in patients suffering from DVT. In contrast, no significant difference regarding CCAs was observed
between the DVT and control group. Furthermore, TEG displayed a better capacity in identifying DVT than CCAs.
In addition, Pearson’s correlation analysis showed TEG and CCA parameters had few correlations.
Conclusion: TEG has advantages in identifying DVT and detecting hypercoagulability, and provides a better
insight in evaluating coagulation status in patients with DVT than CCAs.

1. Introduction
Venous thromboembolism (VTE) is a major global burden with more
than 10 million cases occurring every year. The incidence of VTE is
steadily increasing due to population ageing, obesity, cancer, or heart
diseases [1]. VTE, the major cause of hospital-related morbidity and
mortality, mainly manifests as lower extremity deep vein thrombosis
(DVT) and pulmonary embolism. For DVT, it has a high incidence of 1.6
per 1000 inhabitants a year all over the world [2]. Risk factors of DVT
have increased over decades such as hypercoagulability, changes in
blood viscosity, stasis, vascular wall damage, surgery, immobilization,
or cancer [3] Possible signs or symptoms of DVT usually include ex­
tremity pain, swelling, erythema and dilated superficial veins [3]
Compression ultrasonography combined with D-dimer is the first-line
test for DVT diagnosis, which is widely used immediately when the
patient is admitted to hospital.[4,5] Coagulation status of patients is
generally monitored by conventional coagulation assays (CCAs)
including TT, FIB, aPTT, PT, INR or PLT to guide the use of anticoagu­
lants. However, challenging complications such as life-threatening
hemorrhage during treatment with oral anticoagulants and recurrence
after discharge are frequently observed.[3,4] Hence, objective assess­
ment of coagulation status of patients is critical for early diagnosis,
effective treatment and prevention of DVT. Thromboelastography (TEG)
relies upon changes in the viscosity of blood and provides an overview of
multiple coagulation processes from initial thrombin generation to for­
mation of fibrin strands to fibrinolysis.[6] It allows detection of vari­
ables that impact CCAs (such as clotting factor deficiencies), as well as
factors that cannot be easily measured by CCAs (such as clot kinetics
depending upon thrombin generation and fibrinogen concentration,
platelet function, and fibrinolysis).[6] TEG has been recognized as a
uniquely useful tool in the management of hemostasis during major
surgical interventions such as liver transplantation and cardiovascular
procedures as well as obstetrics, trauma, or neurosurgery. [7–13] Its use
has resulted in a reduction in the use of blood products, the rate of re-

* Corresponding author.
E-mail address: kristyfan@hust.edu.cn (C. Fan).
1
The authors contribute equally to this article.

https://doi.org/10.1016/j.cca.2021.06.019
Received 25 April 2021; Received in revised form 4 June 2021; Accepted 10 June 2021
Available online 15 June 2021
0009-8981/© 2021 Elsevier B.V. All rights reserved.
C. Mao et al. Clinica Chimica Acta 520 (2021) 208–213

exploration, and prediction of failures following peripheral arterial
intervention.[9] However, little evidence reveals the validity of TEG in
DVT and the relationship between TEG and CCAs in evaluating coagu­
lation status in patients with DVT. Here, we performed both TEG and
CCAs among DVT patients and healthy controls. We hypothesized that
TEG may show better insights in identifying DVT and evaluating coag­
ulation status in patients with DVT than CCAs.
2. Materials and methods
2.1. Participants
The protocol of our study was approved by the Ethics Committee of
Tongji Medical College, Huazhong University of Science and Technology
(NO: UHCT-IEC-SOP-016–02-01) and conducted in accordance with the
Declaration of Helsinki. During May 1, 2019 to January 31, 2020,
symptomatic patients suffered from pain, swelling or redness in the
lower extremities or asymptomatic patients suspected of deep-vein
thrombosis were admitted to the vascular surgery center in our hospi­
tal. Only direct admissions were included, and patients transferred
hospital-to-hospital were excluded. Among them, patients were diag­
nosed as deep-vein thrombosis through compression ultrasonography or
whole-leg ultrasonography with elevated D-dimers (greater than 0.5
mg/L). We excluded patients who had oral administration of anti-
coagulants or anti-platelet medicines and patients who received short-
term medicine treatment including estrogen therapy within two
weeks. Furthermore, we ruled out pregnant patients, or patients aged
under 20 years old. Finally, 66 eligible patients with DVT and 40 healthy
controls were enrolled in this study. The informed consent was obtained
by all volunteers enrolled in the study in accordance with the respective
local ethical committee guidelines.
2.2. Blood sampling and examination
analysis and GraphPad Prism 8.01 was used for Scatter Plots. Categorical
variables were shown as absolute number and percentage, while
continuous variables were reported as mean ± SD. Independent t test
was used to compare the differences regarding the continuous variables
including age, TEG and CCA parameters between the DVT and control
group. Chi-square test was used to assess the sex difference between the
DVT and control group. Pearson’s correlation was used to determine the
correlation between TEG and CCA parameters among the study popu­
lation. Heatmaps were drawn according to the Pearson’s correlation
coefficient. P value<0.05 was considered statistically significant.
3. Results
3.1. Demographic characteristics of the study population
During the study period, a total of 66 eligible patients diagnosed as
DVT with a mean age of 56.32 ± 16.22 years, were enrolled in this study.
In contrast, 40 healthy individuals were recruited as controls with a
mean age of 56.9 ± 14.5 years. There were 41 and 27 males in the DVT
and control group respectively (Table 1). No significant differences
regarding age and sex were observed between the DVT and control
group.
3.2. TEG and CCA characteristics of patients with DVT and controls
Blood samples from patients and controls were tested by TEG and
CCAs with results listed in Table 1 and Fig. 1. R, K, Angle, MA, G, CI from
TEG and CCA parameters including TT, FIB, aPTT, INR, PT, TT, MPV,
PLT combined with D-dimer were recorded. We observed only R value
from TEG had no significant difference between patients with DVT and
controls, while Angle, MA, G, CI were significantly higher (P < 0.0001),
and K was markedly lower (P < 0.0001) in DVT group compared with

Blood sample was collected as long as the patient was admitted to our Table 1
center before any operation and analyzed within 4 h. Ultrasonography Demographic, TEG, and CCA characteristics of patients with DVT and healthy
was performed within 6 h to confirm deep-vein thrombosis. controls.
For TEG, samples were tested using a TEG 5000 Analyzer (CFMS Reference DVT (n = Controls (n = P value
LEFU-8800, Beijing, China) immediately after the blood samples were Interval 66) 40)

sent to the laboratory. Briefly, blood samples were citrated and then Age (years) N/A 56.32 ± 56.9 ± 14.5 0.8527a
mixed in a kaolin vial according to the manufacturer’s guidelines. Then 16.22
Male, n (%) N/A 41 (62.1) 27 (67.5) 0.8000b
samples were placed into a TEG cuvette and recalcified. All samples
R (min) 4–9 5.615 ± 5.578 ± 0.745 0.9150a
were run at 37℃ within 2 h. The TEG machines underwent quality 2.149
control assessment. If the samples do not meet the standards, they will K (min) 1–3 1.347 ± 1.968 ± 0.390 <0.0001 a
be re-run. The TEG parameters were recorded including reaction time 0.626
(R), coagulation time (K), alpha angle (Angle), maximum amplitude Angle 53–72 71.82 ± 64.51 ± 4.27 <0.0001 a
8.066
(MA), and clot strength (G). Coagulation index (CI), which linearly in­ MA (min) 50–70 67.63 ± 59.71 ± 3.961 <0.0001 a
corporates R, K, MA, and Angle and provides a global view of a patient’s 7.604
coagulation status, was determined as follows: CI = -0.6516R-0.3772 K G (d/sc) 4500–11000 11216 ± 7523 ± 1253 <0.0001 a
+ 0.1224MA + 0.0759Angle − 7.7922. In TEG analysis, “Hypercoagu­ 3828
CI − 3.0–3.0 1.77 ± 0.036 ± 0.914 <0.0001 a
lable TEG” was defined as R below 4 min, K below 1 min, Angle above 72
2.539
degrees, MA above 70 mm, G above 11,000 d/second, and/or CI above FIB (g/L) 2–4 6.186 ± 2.797 ± 0.364 <0.0001 a
3. These parameters represent key contributors for thrombus formation 5.207
including cascade activation, thrombin formation and fibrin cross- aPTT (s) 28–43.5 39.25 ± 37.88 ± 2.91 0.5740 a
linking, and thrombus strength. LY30 was not included as it did not 15.24
PT (s) 11–16 13.19 ± 12.78 ± 0.6617 0.6005 a
reflect hypercoagulable state.
4.809
For CCAs, blood samples were collected and mixed with sodium INR 0.8–1.31 6.125 ± 0.979 ± 0.0653 0.0345 a
citrate and tested for conventional coagulation. The results included 15.16
thrombin time (TT), plasma fibrinogen (FIB), activated partial throm­ TT (s) 14–21 28.94 ± 17.46 ± 1.43 0.0014 a
22.11
boplastin time (aPTT), international normalized ratio (INR), pro­
MPV (fL) 8–12 9.748 ± 10.08 ± 0.8866 0.3457 a
thrombin time (PT). We also enrolled mean platelet volume (MPV) and 2.065
platelet count (PLT) as they tightly related to thrombus formation. PLT (G/L) 125–350 249 ± 152.5 203.4 ± 45.5 0.0682 a
D-dimer <0.5 4.627 ± 0.338 ± 0.3232 <0.0001 a
2.3. Statistical analysis (mg/L) 4.966

Data are presented as mean ± SD for TEG and CCA parameters. a Independent t-
IBM SPSS Version 23.0 and R software were used for statistical test, b Chi-square test.

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C. Mao et al. Clinica Chimica Acta 520 (2021) 208–213

Fig. 1. The comparison of TEG or CCA values between the patients with DVT and controls. Data are mean ± SD, n = 66 in patient group, n = 40 in control
group. *P < 0.05, **P < 0.01, ****P < 0.0001.

control group. In contrast, there was no significant difference regarding
CCA parameters including aPTT, PT, MPV, PLT between DVT and con­
trol group. FIB was significantly higher (P < 0.0001) in patients with
DVT in accordance with previous observations.[2,14] D-dimer, worked
as a diagnostic parameter for DVT, was notably higher (P < 0.0001) in
DVT group as expected. Here, we excluded TT since it would prolong in
the presence of degradation products of fibrin/fibrinogen including D-
dimer.[15] We also excluded INR as it was derived from PT and designed
to standardize anticoagulation therapy.[16] Together, the above results
showed that most TEG values (except R) in DVT group were significantly
different from the control group, suggesting a hypercoagulable tendency
in patients with DVT. However, aPTT, PT, MPV or PLT from CCAs in
DVT group did not significantly differ from those in the control group,
indicating they are incapable to show hypercoagulable status in patients
with DVT.
3.3. The ability of TEG and CCAs in identifying DVT among the study
population
We calculated the proportion of patients who were tested abnormal
regarding TEG or CCA parameters (Table 2). Among all the parameters,
hypercoagulable TEG showed the strongest capacity in identifying DVT
indicated by 53 of 66 (80.3%) patients with DVT tested abnormal
through hypercoagulable TEG. FIB was the second-best in identifying
DVT indicated by 50 of 66 (75.8%) patients displaying elevated fibrin­
ogen plasma level. In addition, 68.2% patients showed increased Angle
values, suggesting Angle had a relatively preferable capacity in identi­
fying DVT compared to the rest parameters. However, CCAs including
aPTT, PT, INR, TT, MPV and PLT exhibited undesired results in DVT
patients. Together, these data suggest hypercoagulable TEG may be used
as an indicator in identifying DVT.

Table 2
The ability of TEG and CCA parameters in identifying DVT.
Parameters Hypercoagulable R K Angle MA G CI FIB aPTT PT INR TT MPV PLT
TEG

Patients tested 53 (80.3) 13 22 45 28 32 26 50 32 19 19 32 19 25

abnormal, n (19.7) (33.3) (68.2) (42.4) (48.5) (39.4) (75.8) (48.5) (28.8) (28.8) (48.5) (28.8) (37.9)
(%)

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3.4. Correlation analysis of TEG and CCA parameters in patients with
DVT.
To assess whether TEG parameters correlate with CCAs in patients
with DVT, we calculated the Pearson’s correlation coefficients between
all the parameters and displayed the results by a heat-map visualization
in Fig. 2 with P values listed in Table 3. We found R positively correlated
with TT (P < 0.01) and aPTT (P < 0.05), indicating R, together with TT
and aPTT, can reflect the adequacy of coagulation factors since all of
them work during the initiation phase of enzymatic factor activity.
Other TEG parameters including K, Angle, MA, G, and CI significantly
correlated with MPV and PLT (all P < 0.05), suggesting platelets are
closely associated with thrombus formation and play crucial roles in clot
formation, development and strengthening. However, these TEG pa­
rameters (except R) showed no significant correlation with FIB, aPTT,
PT, INR or D-dimer. The results were reasonable since these TEG pa­
rameters share information in different hemostasis phases with FIB,
aPTT, PT, INR or D-dimer.
3.5. Correlation analysis of TEG and CCA parameters in hypercoagulable
TEG patients with DVT.
To further explore the correlation of TEG parameters with CCAs in
hypercoagulable status induced by DVT, we performed the Pearson’s
correlation analysis on DVT patients who had hypercoagulable TEG
values and excluded some inappropriate (TT and INR), calculated (G), or
uninterested (MPV and D-dimer) parameters. The results of the Pear­
son’s correlation coefficients were displayed in a heat-map in Fig. 3 with
P values listed in Table 4. We observed MA (P < 0.001) from TEG
showed the strongest correlation with PLT, indicating platelets are
essential to clot strength. K (P < 0.05) also significantly correlated with
PLT, suggesting platelets are tightly associated with clot development.
In addition, Angle (P < 0.05) and MA (P < 0.05) significantly correlated
with FIB, indicating fibrinogen also plays an important role in clot
development and strengthening. Interestingly, we found R had no sig­
nificant correlation with FIB, aPTT, or PT in CCAs. In addition, PT and
aPTT did not significantly correlated with any parameters from TEG.
4. Discussion
In this study, we performed TEG and CCAs on patients with DVT and
Fig. 2. Pearson’s correlation coefficient between parameters from TEG
and CCAs in patients with DVT shown in a heat-map visualization. Data
were represented in a rectangular matrix where individual values were differ­
entiated by red or blue color.
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Clinica Chimica Acta 520 (2021) 208–213
healthy controls to compare the differences in evaluating coagulation
status and explored the relationships between TEG and CCA parameters.
We found a hypercoagulable tendency among patients with DVT
detected by TEG but not by CCAs (aPTT, PT, MPV, PLT). Furthermore,
hypercoagulable TEG exhibited the strongest capacity in identifying
DVT than any other parameters in CCAs. In addition, parameters
regarding platelets showed some correlations with TEG parameters
among DVT patients, while few correlations were observed between
most TEG and CCA parameters, indicating a discrepancy in assessing
coagulable status between TEG and CCAs.
Hypercoagulable status has been proven to increase the risk of DVT
and is associated with the occurrence of DVT.[3] Objective assessment
or early detection of hypercoagulability allows for prophylactic mea­
sures in DVT or other thrombotic complications, and modification of
anti-coagulation therapy during treatment or surgery. In recent decades,
researchers found TEG may identify hypercoagulability in diverse
thromboembolic events. Hvitfeldt Poulsen et al[17] reported that pa­
tients with a previous history of venous or arterial thromboembolic
event had some TEG parameters consistent with hypercoagulability as
compared with healthy controls. Brill et al[12] studied 983 patients with
trauma and found that the risk of DVT was doubled in patients in whom
the TEG was consistent with a hypercoagulable state. Furthermore,
hypercoagulable TEG predicted DVT with a high sensitivity of 91.9%.
[12] Another retrospective study of TEG in over 1800 patients with
severe extremity fractures concluded that the increased MA value from
TEG was associated with the increased risk of in-hospital DVT and
pulmonary embolism with a 3.6-fold and 6.7-fold respectively.[13]
Here, we also observed significant differences regarding TEG parameters
including K, Angle, MA, G and CI between patients with DVT and
healthy controls (Table 1 and Fig. 1). The decreased K, or increased
Angle, MA, G, or CI validated a hypercoagulable tendency in DVT pa­
tients. However, R value showed no significant difference between pa­
tients and controls, indicating that the coagulation factor activity
preceding the initial clot formation was not deficient. This is consistent
with the observations from Spiezia and colleagues in DVT patients.[18]
Park et al[19] also observed the change of Angle and MA but not R in
patients with DVT. In contrast, Cho and colleagues[20] presented work
showing that the R time in patients with DVT development was signif­
icantly shorter than patients without DVT (P < 0.001). This might be
explained by a different selection of mixed population consisting of
trauma and surgery patients with a screening DVT rate of 28% in their
study.[20] The shortened R was also found in the work from Hvitfeldt
Poulsen and colleagues.[17] The discrepancy may be explained by a
diverse selection of patients who were in different phases of DVT or
different methods used (tissue factor activation) for TEG assessment. In
addition, we observed the hypercoagulable TEG exhibited a strong ca­
pacity in identifying DVT than other parameters from CCAs (Table 2).
These combined results suggest TEG may be used as an objective
assessment of hypercoagulability and provide a comprehensive evalu­
ation of the viscoelastic properties of whole blood in patients with DVT.
In our study, FIB was significantly higher in DVT patients, which is in
line with other observations that patients suffer from DVT have higher
levels of fibrinogen as compared with controls.[2,18] These results
indicate FIB may also work as an indicator of DVT, though it has a lower
capacity than hypercoagulable TEG in identifying DVT among the study
population (Table 2). Interestingly, no significant differences were
observed regarding CCAs including PT, aPTT between DVT patients and
controls. Moreover, these parameters showed relatively undesired re­
sults in identifying DVT or indicating hypercoagulability among patients
(Table1, 2). Consistently, Park et al[19] provided evidence that aPTT
and PT were not able to show an indication of when a patient was in a
hypercoagulable status. Other researchers also found PT and aPTT were
not reliable predictors of a clinically significant hypercoagulable state
such as DVT.[12,21] However, in practical terms, PT and aPTT are still
widely used as indicators for hypercoagulability or hypocoagulability,
though they are designed to evaluate clotting factor deficiencies.[22] In
C. Mao et al. Clinica Chimica Acta 520 (2021) 208–213

Table 3
P values from Pearson’s correlation between parameters in patients with DVT.
R K Angle MA G CI TT FIB aPTT INR PT MPV PLT D-dimer

R NA 0.00 0.00 0.07 0.26 0.00 0.00 0.79 0.01 0.70 0.05 0.37 0.67 0.32
K 0.00 NA 0.00 0.00 0.00 0.00 0.29 0.18 0.25 0.67 0.23 0.02 0.00 0.20
Angle 0.00 0.00 NA 0.00 0.00 0.00 0.15 0.09 0.14 0.28 0.10 0.01 0.02 0.39
MA 0.07 0.00 0.00 NA 0.00 0.00 0.38 0.84 0.37 0.29 0.44 0.01 0.00 0.28
G 0.26 0.00 0.00 0.00 NA 0.00 0.31 1.00 0.31 0.24 0.34 0.01 0.00 0.26
CI 0.00 0.00 0.00 0.00 0.00 NA 0.03 0.65 0.10 0.77 0.19 0.02 0.00 0.20
TT 0.00 0.29 0.15 0.38 0.31 0.03 NA 0.03 0.00 0.00 0.00 0.16 0.01 0.19
FIB 0.79 0.18 0.09 0.84 1.00 0.65 0.03 NA 0.00 0.00 0.00 0.21 0.01 0.00
aPTT 0.01 0.25 0.14 0.37 0.31 0.10 0.00 0.00 NA 0.00 0.00 0.03 0.00 0.00
INR 0.70 0.67 0.28 0.29 0.24 0.77 0.00 0.00 0.00 NA 0.00 0.01 0.00 0.00
PT 0.05 0.23 0.10 0.44 0.34 0.19 0.00 0.00 0.00 0.00 NA 0.07 0.00 0.00
MPV 0.37 0.02 0.01 0.01 0.01 0.02 0.16 0.21 0.03 0.01 0.07 NA 0.01 0.35
PLT 0.67 0.00 0.02 0.00 0.00 0.00 0.01 0.01 0.00 0.00 0.00 0.01 NA 0.05
D-dimer 0.32 0.20 0.39 0.28 0.26 0.20 0.19 0.00 0.00 0.00 0.00 0.35 0.05 NA

Fig. 3. Pearson’s correlation coefficient between interested parameters
from TEG and CCAs among hypercoagulable TEG patients with DVT. Data
were represented in a rectangular matrix where individual values were differ­
entiated by red or blue color.
our study, we further observed PT and aPTT were difficult to relate to
TEG data in DVT patients (Table1, 2). Given that PT and aPTT are iso­
lated static tests and end with the formation of the first fibrin strand,
they are unable to generate data at all phases of clot development like
TEG. These combined results suggest that using PT or aPTT to assess
hypercoagulable state or predict the occurrence of thromboembolic
events is not reliable or objective.
In addition, our data showed MPV and PLT had significant correla­
tions with most TEG parameters in DVT patients (Fig. 2, Table 3), and
PLT showed strong correlations with some TEG parameters in hyper­
coagulable TEG patients with DVT (Fig. 3, Table 4). These data suggest
that platelets play an essential role in the process of clot formation and
clot strengthening. However, MPV and PLT did not show significant
differences between patients and controls in this study (Table 1 and
Fig. 1). Some observations showed MPV was higher in DVT patients,
[23–25] while Lippi et al[26] found MPV was significantly lower in
patients diagnosed with DVT. The inconsistency may be due to the an­
ticoagulants used for sampling since citrate blood samples revealed
smaller MPV than EDTA.[27] Another possibility is the timing for
measurement after sampling. In general, the MPV increases up to 30%
within 5 min storage and increases further by 10% to 15% over the next
2 h.[28,29] However, MPV has not been proven as a marker for platelet
function.[30] Platelets with a higher MPV are expected to be seen in
destructive thrombocytopenia when megakaryocytic stimulation is
present.[31] Conversely, low MPV is associated with marrow hypoplasia
or aplasia.[31] Similarly, PLT provides data about how many platelets
are present, but gives no information about how they function. Thus,
MPV and PLT may provide information to estimate platelet activity
available for hemostasis but they lack sufficient sensitivity to detect
coagulation changes in patients. In contrast, TEG allows global evalua­
tion of clot formation process and takes into account the interaction of
the coagulation factors with platelets and other blood cell elements.[32]
Our data showed PLT had the strongest correlation with MA in both
study population (Figs. 2, 3). MA, which is the maximum distance
traveled by the cross-linked cup/pin, is able to reflect maximum clot
strength and is largely a reflection of platelet function or activity.[6]
Studies have demonstrated MA could detect platelet dysfunction in
multiple diseases.[33–35] Thus, TEG may better reflect the contribution
of platelets including the number or function than MPV or PLT in
monitoring hypercoagulability or predicting the incidence of thrombo­
embolic events.
However, our study has some limitations. For example, it was an
observational single-center study with a relatively small sample size.
Prospective large studies are needed to better define the potential clin­
ical applications of TEG in the management of DVT patients. Moreover,
the cutoff values in TEG or CCAs were determined according to the
manufacturers’ recommendations and laboratory ranges, so other cutoff

Table 4
P values from Pearson’s correlation between parameters among hypercoagulable TEG patients with DVT.
R K Angle MA CI FIB aPTT PT PLT

R NA 0.06 0.02 0.32 0.00 0.80 0.22 0.22 0.60

K 0.06 NA 0.00 0.00 0.00 0.08 0.45 0.45 0.01
Angle 0.02 0.000 NA 0.00 0.00 0.03 0.16 0.16 0.36
MA 0.32 0.00 0.00 NA 0.00 0.04 0.91 0.91 0.00
CI 0.00 0.00 0.00 0.00 NA 0.12 0.64 0.64 0.05
FIB 0.80 0.08 0.03 0.04 0.12 NA 0.12 0.12 0.02
aPTT 0.22 0.45 0.16 0.91 0.64 0.12 NA 0.00 0.64
PT 0.22 0.45 0.16 0.91 0.64 0.12 0.00 NA 0.64
PLT 0.60 0.01 0.36 0.00 0.05 0.02 0.64 0.64 NA

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C. Mao et al.
values may yield different predictive outcomes. In addition, though this
study provides some information on TEG and CCAs in patients with DVT,
no data are presently available on the follow-up of the patients. It would
be interesting to observe the change of TEG and CCA values and
compare these parameters before and after treatment or in different time
points from admission to discharge.
5. Conclusions
TEG provides a comprehensive evaluation of the viscoelastic prop­
erties of whole blood and provides a better insight into the coagulation
status than CCAs in patients with DVT. TEG has advantages in identi­
fying DVT and assessing hypercoagulability, allowing for prophylactic
measures for the prevention of DVT and early management of throm­
boembolic events.
CRediT authorship contribution statement
Chaoqin Mao: Resources, Data curation, Writing - original draft.
Yueshan Xiong: Methodology, Formal analysis, Writing - original draft.
Cheng Fan: Conceptualization, Resources, Writing - review & editing,
Supervision.
Declaration of Competing Interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Acknowledgements
The authors thank all participants for providing their blood samples.
Sources of Funding
This work was supported by the National Natural Science Foundation
of China (Grant Number 81900142, 11801186) and Natural Science
Foundation of Hubei Province of China (Grant Number 2017CFB170).
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