Research progress on clot waveform analysis in thrombotic diseases
10.13303/j.cjbt.issn.1004-549x.2025.10.020
- VernacularTitle:凝固曲线波形分析在血栓性疾病中的研究进展
- Author:
Jingsong BAI
1
;
Han QIN
2
;
Guo LI
1
;
Jian LIAO
1
;
Ying XU
3
Author Information
1. Department of Clinical Laboratory, The First Affiliated Hospital of Traditional Chinese Medicine of Chengdu Medical College, Xindu Hospital of Traditional Chinese Medicine/TCM Preventative Treatment Research Center of Chengdu Medical College, Chengdu 610500, China
2. Department of Blood Transfusion, Dalian Third People's Hospital, Dalian 116039, China
3. Department of Clinical Laboratory, The First Affiliated Hospital of Traditional Chinese Medicine of Chengdu Medical College, Xindu Hospital of Traditional Chinese Medicine/TCM Preventative Treatment Research Center of Chengdu Medical College, Chengdu 610500, China; Department of Clinical Laboratory, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
- Publication Type:Journal Article
- Keywords:
clot waveform analysis(CWA);
thrombotic diseases;
hypercoagulable state;
clot-fibrinolysis waveform analysis;
anticoagulant monitoring
- From:
Chinese Journal of Blood Transfusion
2025;38(10):1427-1434
- CountryChina
- Language:Chinese
-
Abstract:
In recent years, with the continuous advancement of related research, the clinical value of clot waveform analysis (CWA) in the diagnosis and management of thrombotic diseases has become increasingly prominent. As a dynamic coagulation monitoring technology based on optical principles, CWA overcomes the limitations of traditional coagulation tests (e.g., APTT, PT), which rely on single time-point parameters, in identifying hypercoagulable states, predicting thrombotic risk, and monitoring anticoagulant efficacy. By analyzing the kinetic profiles of the coagulation cascade, CWA provides multidimensional insights. This article elucidates the theoretical basis and principles of CWA, systematically reviews its applications in arterial/venous thrombosis, other hypercoagulability-related disorders, and anticoagulation therapy monitoring, and synthesizes recent advances of CWA for thrombotic diseases. Specifically, multiple studies demonstrate that CWA-APTT parameters (e.g., peak height Min1, Min2, Delta) can sensitively detect hypercoagulability. Combining CWA with the Padua score significantly enhances the predictive power for venous thromboembolism (VTE) risk assessment. CWA shows clinical utility in evaluating hypercoagulability in patients with acute myocardial infarction (AMI) and acute cerebral infarction (ACI), where parameters such as Min1, Min2, and Max2 exhibit greater sensitivity than conventional APTT. These metrics may predict AMI complications and guide clinical management. Additionally, CWA demonstrates value in diverse scenarios including pregnancy, inflammation-associated hypercoagulability (e.g., COVID-19, Kawasaki disease), and rare thrombotic conditions (e.g., chronic spontaneous urticaria). Beyond diagnostic and risk-stratification advantages, CWA serves as a novel tool for personalized anticoagulation monitoring. Its derivative technology, clot-fibrinolysis waveform analysis (CFWA), extends applications to fibrinolysis assessment—aiding in identifying coagulation status in deep vein thrombosis (DVT) patients, tracking coagulation/fibrinolysis dynamics in COVID-19, and evaluating efficacy of anticoagulant/antifibrinolytic therapies. Nevertheless, despite its unique strengths, challenges such as device dependency, insufficient standardization, and heterogeneity in parameter interpretation hinder widespread clinical adoption, necessitating further investigation. Future directions include establishing multidimensional thrombotic risk assessment systems integrating CWA and developing AI-powered automated CWA analysis platforms to enhance clinical accessibility.
