{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:32:39Z","timestamp":1788201159993,"version":"build-2803163510"},"reference-count":46,"publisher":"Sociedade Brasileira de Cardiologia","issue":"8","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  Pacientes com fibrila\u00e7\u00e3o atrial (FA) apresentam risco elevado de embolia pulmonar (EP), por\u00e9m as ferramentas de predi\u00e7\u00e3o existentes demonstram precis\u00e3o limitada.  Objetivos  Este estudo teve como objetivo desenvolver e validar um novo modelo preditivo que integra par\u00e2metros de tromboelastografia (TEG) com marcadores de coagula\u00e7\u00e3o convencionais para avalia\u00e7\u00e3o do risco de EP em pacientes com FA.  M\u00e9todos  Realizamos um estudo retrospectivo com 271 pacientes hospitalizados com FA submetidos a angiotomografia computadorizada pulmonar (angioTC) para investiga\u00e7\u00e3o de EP (41 com EP, 230 sem). A idade m\u00e9dia foi de 76,5 anos, 56,5% eram do sexo masculino e a hipertens\u00e3o foi a comorbidade mais comum (67,5%). O diagn\u00f3stico de EP foi confirmado por angiotomografia computadorizada pulmonar. Foram analisadas as caracter\u00edsticas basais, os par\u00e2metros da TEG (incluindo tempo de rea\u00e7\u00e3o, amplitude m\u00e1xima [AM] e \u00e2ngulo \u03b1) e os marcadores de coagula\u00e7\u00e3o padr\u00e3o (d\u00edmero-D, fibrinog\u00eanio). A signific\u00e2ncia estat\u00edstica foi definida como um valor de p bicaudal &lt; 0,05. A regress\u00e3o log\u00edstica multivariada identificou preditores independentes, que foram incorporados a um nomograma. O desempenho do modelo foi avaliado por meio de an\u00e1lise da curva ROC (caracter\u00edstica de opera\u00e7\u00e3o do receptor), curvas de calibra\u00e7\u00e3o e an\u00e1lise da curva de decis\u00e3o (ACD).  Resultados  A preval\u00eancia de EP foi de 15,1%. Pacientes com EP apresentaram n\u00edveis significativamente mais elevados de TEG-AM, d\u00edmero-D e fibrinog\u00eanio em compara\u00e7\u00e3o ao grupo sem EP (todos com p &lt; 0,05). A an\u00e1lise multivariada identificou esses tr\u00eas marcadores como preditores independentes. O nomograma demonstrou excelente discrimina\u00e7\u00e3o (AUC = 0,878, IC 95%: 0,806-0,949), com sensibilidade de 87,8% e especificidade de 78,0% no ponto de corte ideal. O modelo apresentou boa calibra\u00e7\u00e3o (p de Hosmer-Lemeshow = 0,965) e significativa utilidade cl\u00ednica.  Conclus\u00e3o  O nomograma baseado em TEG, que combina AM, d\u00edmero-D e fibrinog\u00eanio, fornece uma estratifica\u00e7\u00e3o de risco de EP precisa e acess\u00edvel \u00e0 beira do leito para pacientes com FA. Essa ferramenta pode facilitar a identifica\u00e7\u00e3o precoce de indiv\u00edduos de alto risco e orientar a tomada de decis\u00f5es cl\u00ednicas em rela\u00e7\u00e3o \u00e0 terapia anticoagulante. Estudos prospectivos adicionais s\u00e3o necess\u00e1rios para validar esses achados.<\/jats:p>","DOI":"10.36660\/abc.20250683","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:55:31Z","timestamp":1788198931000},"source":"Crossref","is-referenced-by-count":0,"title":["Um Modelo Preditivo para Embolia Pulmonar em Pacientes com Fibrila\u00e7\u00e3o Atrial Baseado em Tromboelastografia e Par\u00e2metros de Coagula\u00e7\u00e3o"],"prefix":"10.36660","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7788-0655","authenticated-orcid":false,"given":"Xingqi","family":"Huang","sequence":"first","affiliation":[{"name":"Jinhua Guangfu Oncology Hospital,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1974-5606","authenticated-orcid":false,"given":"Jianmei","family":"Liu","sequence":"additional","affiliation":[{"name":"Jinhua Guangfu Oncology Hospital,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22636","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"36","key":"ref1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the Management of Atrial Fibrillation Developed in Collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder IC","year":"2024","journal-title":"Eur Heart J"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar JA","year":"2024","journal-title":"Circulation"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1160\/TH14-05-0405","article-title":"Atrial Fibrillation Associated with Increased Risk of Venous Thromboembolism. 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