Predicting Cerebral Small Vessel Disease Burden Based on Thromboelastography in Patients with Acute Ischemic Stroke: A Pilot Study

BACKGROUND This study aimed to investigate the relationship between the coagulation function measured by thromboelastography (TEG) in patients with acute ischemic stroke (AIS) and total burden of cerebral small vessel disease (CSVD), to further establish a nomogram tool based on regular clinical risk factors and TEG, to conveniently predict the risk of high-grade white matter hyperintensities (WMH) and CSVD burden in AIS patients. MATERIAL AND METHODS A cross-sectional study included 143 AIS patients who underwent TEG tests and 3.0T head MRI scans after admission. They were grouped according to total burden CSVD score and WMH Fazekas score. Differences in regular clinical data (RCD), TEG, and conventional coagulation tests (CCT) between groups were compared. Three sets of logistic regression models were established: RCD model, and models combining RCD with TEG and CCT respectively, to evaluate their predictive performance for WMH and SVD in patients with AIS. RESULTS Univariate analysis revealed age, hypertension, stroke history, fibrinogen, and TEG indicators maximum amplitude, Angle, K, and coagulation index were risk factors for increased WMH Fazekas score and CSVD burden in patients with AIS (OR>1, P<0.05). Logistic regression model combining RCD and TEG had a higher AUC value in predicting WMH (Fazekas score ≥2) and SVD (SVD burden score ≥3). CONCLUSIONS TEG parameters of patients with AIS are related to CSVD burden and its imaging features. Based on regular clinical risk factors, TEG can provide additional predictive information on the severity of WMHs and the burden of CSVD in patients with AIS.