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ROTEM Can Predict Thrombotic Events in Rheumatoid Arthritis

July 23, 2018
Gregory M. Weiss, MD

Although disease activity remains the key risk factor, this test can identify a greater predisposition to thrombosis.

Reference1. Türk SM, Cansu DÜ, Teke HÜ, et al. Can we predict thrombotic tendency in rheumatoid arthritis? A thromboelastographic analysis (with ROTEM). Clin Rheumatol. 2018 May 7. doi: 10.1007/s10067-018-4134-y. [Epub ahead of print]

Türk and fellow researchers in Turkey recently found not only that increased disease activity promotes thrombotic risk in patients with rheumatoid arthritis (RA), but also that rotational thromboelastometry (ROTEM) can predict thrombotic events in those patients.1

Thumb through the slides for the details of the study and the take-home points for physicians.

(Image credit: ©Andrey Popov/Shutterstock.com)

Thromboelastography (TEG) is a method that enables in vitro evaluation of clot formation, clot firmness, and fibrinolysis in whole blood sample. Rotational thromboelastometry (ROTEM) originates from TEG and is a further modified and modernized version of TEG.

ROTEM/TEG is not commonly used in rheumatology practice.

DAS-28, Disease Activity Score-28; E-CFT, extrinsic clot formation time; I-CFT, intrinsic clot formation time; I-MCF, intrinsic maximum clot firmness; ROTEM, rotational thromboelastometry.

I-MCF was 60 ± 4.6 mm in patients with moderate disease activity, 61 ± 6.5 mm in those with low disease activity, and 61.4 ± 5.4 mm in those in remission (P =.033).

CRP, C-reactive protein; DAS-28, Disease Activity Score-28; ESR, erythrocyte sedimentation rate; I-CFT, intrinsic clot formation time; ROTEM, rotational thromboelastometry.

Patients with RA had higher ESR, CRP and D-dimer levels, and platelet counts (P = .006, P = .001, P = .002, and P = .015, respectively).

ROTEM, rotational thromboelastometry; TEG, thromboelastography.

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