Defining three coagulation-based phenotypes for OHCA patients undergoing ECPR: an unsupervised cluster analysis

Clicks: 13
ID: 337494
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #40 of 42 articles by views in European Heart Journal Acute Cardiovascular Care

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
INTRODUCTION: Coagulopathy is frequent in refractory out-of-hospital cardiac arrest (OHCA) patients treated with extracorporeal cardiopulmonary resuscitation (ECPR), yet its prognostic significance and heterogeneity remain poorly characterised. OBJECTIVES: To characterize coagulopathy at ECPR initiation, identify coagulation phenotypes, evaluate their association with outcomes, and describe their temporal evolution. METHODS: All consecutive refractory OHCAs treated with ECPR (2013-2024) were included. Phenotypes were identified by unsupervised K-means clustering on PT-INR, aPTT, platelets, antithrombin, fibrinogen, and D-dimer measured at ECPR initiation. Associations with survival, neurological outcomes, and complications were assessed by multivariable logistic regression. RESULTS: Of 406 ECPR patients, 360 had coagulation data for analysis (initial shockable rhythm 67%, low-flow 70 min [IQR 58-81]). Three phenotypes were identified: severe consumptive coagulopathy (phenotype 1, n=49, 13.6%), mild consumptive coagulopathy (phenotype 2, n=175, 48.6%), and preserved coagulation (phenotype 3, n=136, 37.8%). Phenotype 1 had no survivors, compared with survival of 8.6% and 33.1% in phenotypes 2 and 3, respectively; favourable neurological outcome was achieved in 0%, 5.1%, and 17.6%. Phenotype severity correlated with ischaemic burden (lactate, arterial pH, end-tidal CO2, and low-flow duration). On multivariable analysis, phenotype 2 was associated with lower survival (OR 0.25, 95% CI 0.12-0.55) and favourable neurological outcome (OR 0.31, 95% CI 0.12-0.81) versus phenotype 3. Bleeding incidence rates were 38, 12, and 2.5 events per 100 patient-days in phenotype 1, 2, and 3, respectively (all p < 0.001). CONCLUSIONS: Three distinct coagulation phenotypes at ECPR initiation were independently associated with survival and neurological outcome and appear to reflect ischaemic injury severity. These findings require validation in independent cohorts before clinical application.
Reference Key
openalex_W7223795366 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Tommaso Scquizzato, Evgeny V. Fominskiy, Maria Grazia Calabró, Annalisa Franco, Savino Altizio, Pasquale Nardelli, Alessandro Ortalda, Claudia Francescon, Giovanna Basile, Mario Gramegna, Silvia Delrio, Christophe Vandenbriele, Marina Pieri, Anna Mara Scandroglio
Are you one of these authors? Claim your profile
Journal European Heart Journal Acute Cardiovascular Care
Year 2026
DOI
10.1093/ehjacc/zuag134
URL
https://doi.org/10.1093/ehjacc/zuag134
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.