Kott, K.A.Morel-Kopp, M.C.Vernon, S.T.Takagi, Y.Di Bartolo, B.A.Peter, K.Yang, J.Y.Grieve, S.M.Ward, C.Figtree, G.A.2023-05-162023-05-162021Journal of the American Heart Association, 2021; 10(20):e020604-1-e020604-252047-99802047-9980https://hdl.handle.net/2440/138388Background: Although the association between dysregulated coagulation and atherosclerosis is well recognized, individual assays have been of minimal value in understanding disease susceptibility. Here we investigated the association of global coagulation profiles with coronary artery disease with consideration of sex differences. Methods and Results: The study included patients from the BioHEART-CT (The BioHEART Study: Assessing Patients With Suspected Cardiovascular Disease for New Disease Markers and Risk Factors) biobank who had computed tomography coronary angiograms scored for coronary artery calcium score (CACS) and Gensini score. The cohort included 206 adult patients who were referred for clinically indicated computed tomography coronary angiography and had a median of 2 major cardiac risk factors; 50% were women and the average age was 62.6 years (±9.9 years). The overall hemostatic potential (OHP) and calibrated automated thrombography generation assays were performed on platelet-poor plasma. CACS and Gensini score in men were significantly correlated in bivariate analysis with measures from the OHP assay, and regression models predicting disease severity by CACS or Gensini score were improved by adding the OHP assay variables in men but not in women. The calibrated automated thrombography generation assay demonstrated a more hypercoagulable profile in women than in men. The OHP assay showed hypercoagulable profiles in women with hyperlipidemia and men with obesity. Conclusions: The OHP assay identified hypercoagulable profiles associated with different risk factors for each sex and was associated with CACS and Gensini score severity in men, emphasizing the associations between increased fibrin generation and reduced fibrinolysis with cardiac risk factors and early atherosclerosis. Registration Information: www.anzctr.org.au. Identifier: ACTRN12618001322224.en© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.atherosclerosishypercoagulabilityrisk factorssexHumansCardiovascular DiseasesThrombophiliaTomography, X-Ray ComputedCoronary AngiographyRisk FactorsAdultMiddle AgedFemaleMaleAtherosclerosisCoronary Artery DiseaseVascular CalcificationHeart Disease Risk FactorsJournal article10.1161/JAHA.120.0206042023-05-15595641Di Bartolo, B.A. [0000-0001-8420-0461]