{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:16:19Z","timestamp":1780352179418,"version":"3.54.1"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Ratchadapiseksompotch Endowment Fund of the Center of Excellence in Hepatic Fibrosis and Cirrhosis research unit","award":["GCE 3300170037"],"award-info":[{"award-number":["GCE 3300170037"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.<\/jats:p>\n                  <jats:p>This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital. The PT- and aPTT-based CWA parameters were obtained using an automated coagulation analyzer.<\/jats:p>\n                  <jats:p>A total of 560 patients with cirrhosis were included; 165 (29.5%) and 47 (11.5%) had Child\u2013Turcotte\u2013Pugh (CTP) B and C cirrhosis, respectively. The PT- and aPTT-based CWA parameters, including maximum velocity (min1), maximum acceleration (min2), and maximum deceleration (max2), were significantly lower (p\u2009\u2264\u20090.05) in patients with decompensated cirrhosis than in those with compensated cirrhosis. Additionally, CWA values were significantly higher in patients with higher CTP and Model for End-Stage Liver Disease (MELD) scores. Multivariable analysis revealed that liver stiffness (LS) and max2 of PT-based CWA assay were independently associated with CTP B\/C. In addition, min2 and max2 of PT-based CWA assay were independently associated with 1-year mortality. No significant differences in CWA parameters were observed between patients with and without portal vein thrombosis. CWA parameters were not related to AD during the 1-year follow-up.<\/jats:p>\n                  <jats:p>A hypocoagulable profile based on CWA parameters is associated with advanced-stage cirrhosis. CWA may be a useful objective marker for assessing cirrhosis severity and predicting 1-year mortality.<\/jats:p>","DOI":"10.1055\/a-2505-8616","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T19:20:04Z","timestamp":1736450404000},"page":"1141-1149","source":"Crossref","is-referenced-by-count":1,"title":["Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis"],"prefix":"10.1055","volume":"125","author":[{"given":"Kessarin","family":"Thanapirom","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Center of Excellence in Liver Fibrosis and Cirrhosis, Chulalongkorn University, Bangkok, Thailand"},{"name":"Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirinporn","family":"Suksawatamnuay","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Center of Excellence in Liver Fibrosis and Cirrhosis, Chulalongkorn University, Bangkok, Thailand"},{"name":"Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panarat","family":"Thaimai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Center of Excellence in Liver Fibrosis and Cirrhosis, Chulalongkorn University, Bangkok, Thailand"},{"name":"Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prooksa","family":"Ananchuensook","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Center of Excellence in Liver Fibrosis and Cirrhosis, Chulalongkorn University, Bangkok, Thailand"},{"name":"Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pitiphong","family":"Kijrattanakul","sequence":"additional","affiliation":[{"name":"Division of Hospital and Ambulatory Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantep","family":"Angchaisuksiri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pisit","family":"Tangkijvanich","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Center of Excellence in Hepatitis and Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sombat","family":"Treeprasertsuk","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyawat","family":"Komolmit","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Center of Excellence in Liver Fibrosis and Cirrhosis, Chulalongkorn University, Bangkok, Thailand"},{"name":"Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/S0168-8278(02)00199-X","article-title":"Haemostatic abnormalities in patients with liver disease","volume":"37","author":"T Lisman","year":"2002","journal-title":"J Hepatol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/jth.15239","article-title":"The concept of rebalanced hemostasis in patients with liver disease: communication from the ISTH SSC working group on hemostatic management of patients with liver disease","volume":"19","author":"T Lisman","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1053\/j.gastro.2009.08.045","article-title":"An imbalance of pro- vs anti-coagulation factors in plasma from patients with cirrhosis","volume":"137","author":"A Tripodi","year":"2009","journal-title":"Gastroenterology"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1053\/j.gastro.2023.05.046","article-title":"Procedural-Related Bleeding in Hospitalized Patients With Liver Disease (PROC-BLeeD): an international, prospective, multicenter observational study","volume":"165","author":"N M 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A systematic review and meta-analysis","volume":"117","author":"P Ambrosino","year":"2017","journal-title":"Thromb Haemost"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.jhep.2021.07.020","article-title":"Predicting portal thrombosis in cirrhosis: a prospective study of clinical, ultrasonographic and hemostatic factors","volume":"75","author":"F Turon","year":"2021","journal-title":"J Hepatol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/hep.27546","article-title":"Causes and consequences of portal vein thrombosis in 1,243 patients with cirrhosis: results of a longitudinal study","volume":"61","author":"F Nery","year":"2015","journal-title":"Hepatology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.ejim.2016.11.007","article-title":"Bleeding after invasive procedures is rare and unpredicted by platelet counts in cirrhotic patients with 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D'Amico","year":"2018","journal-title":"J Hepatol"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.jhep.2021.12.022","article-title":"Baveno VII - renewing consensus in portal hypertension","volume":"76","author":"R de Franchis","year":"2022","journal-title":"J Hepatol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1007\/s11901-019-00473-1","article-title":"Prediction of decompensation in patients with compensated cirrhosis: does etiology matter?","volume":"18","author":"G D'Amico","year":"2019","journal-title":"Curr Hepatol Rep"},{"issue":"06","key":"ref29","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.jceh.2023.05.017","article-title":"Predictors of short-term mortality in patients of cirrhosis of liver presenting as acute kidney injury: an in-hospital prospective observational study","volume":"13","author":"B Musunuri","year":"2023","journal-title":"J Clin Exp Hepatol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"762291","DOI":"10.3389\/fmed.2021.762291","article-title":"Increased INR values predict accelerating deterioration and high short-term mortality among patients hospitalized with cirrhosis or advanced fibrosis","volume":"8","author":"Y Wang","year":"2021","journal-title":"Front Med (Lausanne)"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2505-8616.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T23:46:45Z","timestamp":1761868005000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2505-8616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,9]]},"references-count":30,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,10,30]]},"published-print":{"date-parts":[[2025,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2505-8616","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,9]]}}}