The effect of Mycobacterium tuberculosis treatment on thrombelastography-assessed haemostasis: a prospective cohort study

TL;DR

This study found that treating tuberculosis and tuberculosis infection reduces clot strength, which might lower cardiovascular risks.

Contribution

The study is the first to show that TB treatment affects haemostasis as measured by thrombelastography.

Findings

TB treatment reduced maximum clot strength (MA) from 64.0 to 57.9 mm.

TBI treatment also reduced MA from 61.3 to 58.6 mm.

Other TEG parameters like R, K, Angle, and LY30 remained unchanged.

Abstract

Tuberculosis disease (TB) and tuberculosis infection (TBI) have been associated with increased risk of cardiovascular disease which may be connected to infection-related haemostatic changes. It is unknown if treatment of Mycobacterium tuberculosis influences haemostasis. Here, we assessed if TB or TBI treatment affects thrombelastography (TEG)-assessed haemostasis.

Individuals with TB or TBI were included from a TB outpatient clinic in Copenhagen, Denmark. Patients treated with antithrombotic medication or systemic immunosuppressants were excluded. TEG analysis was performed before and after TB/TBI treatment using the TEG®6s analyser to provide data on the reaction time of clot initiation (R) (min), the speed of clot formation (K) (min) and clot build-up (Angle) (°), maximum clot strength (MA) (mm), and clot breakdown/fibrinolysis (LY30) (%). Differences in TEG were assessed using paired t tests.

We included eleven individuals with TB with median [interquartile range] [IQR] age 52 [32] years and mean (standard deviation) (SD) body mass index (BMI) 24.7 (6.3) kg/m2 as well as 15 individuals with TBI with median [IQR] age 49 [25] years and BMI 26.0 (3.2) kg/m2. Treatment reduced MA for both TB (64.0 (6.3) vs. 57.9 (5.2) mm, p = 0.016) and TBI (61.3 (4.1) vs. 58.6 (5.0) mm, p = 0.023) whereas R, K, Angle and LY30 were unaffected.

TEG analysis showed that treatments of TB and TBI were associated with reduced MA which may indicate the existence of cardiovascular benefits from therapy.

Registered at ClinicalTrials.gov 05 April 2021 with registration number NCT04830462.

The online version contains supplementary material available at 10.1186/s12959-024-00625-4.