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Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery.
J Thorac Cardiovasc Surg. 2005 Aug; 130(2):303-8.JT

Abstract

OBJECTIVE

This study investigated whether the activation of coagulation, fibrinolysis, and endothelium occurring during the first postoperative month after on-pump coronary artery bypass surgery differs from that after off-pump coronary artery bypass grafting.

METHODS

Thirty-five patients candidates to coronary surgery were randomized to undergo on-pump (n = 18) or off-pump (n = 17) coronary artery bypass grafting. Blood samples were collected before the intervention and to 1 month after surgery.

RESULTS

Prothrombin fragment F1.2, thrombin-antithrombin complex, and D-dimer increased after surgery and were persistently higher than preoperative values as late as 30 postoperative days in both on- and off-pump groups; higher levels of these variables were detected after on-pump surgery relative to off-pump surgery only at the time point after termination of cardiopulmonary bypass (fragment F1.2 and thrombin-antithrombin complex) or from bypass end to 8 postoperative days (D-dimer). Fibrinogen levels decreased after surgery and then increased in parallel in both groups to 8 days after surgery. The von Willebrand factor level increased postoperatively in both groups and returned to baseline 30 days after surgery; it was higher after on-pump surgery from bypass end to 8 postoperative days. Soluble vascular cell adhesion molecule 1 was increased significantly from baseline in both groups 30 days after surgery, with no difference between groups.

CONCLUSION

Patients undergoing off-pump surgery showed protection against activation of coagulation and fibrinolysis and against endothelial injury only during the intraoperative period; this was followed by the development of a prothrombotic pattern comparable to that of patients undergoing on-pump surgery lasting at least as late as 30 days after surgery.

Authors+Show Affiliations

Department of Cardiac Surgery, University of Milan, Italy. alessandro.parolari@cardiologicomonzino.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16077391

Citation

Parolari, Alessandro, et al. "Increased Prothrombotic State Lasting as Long as One Month After On-pump and Off-pump Coronary Surgery." The Journal of Thoracic and Cardiovascular Surgery, vol. 130, no. 2, 2005, pp. 303-8.
Parolari A, Mussoni L, Frigerio M, et al. Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery. J Thorac Cardiovasc Surg. 2005;130(2):303-8.
Parolari, A., Mussoni, L., Frigerio, M., Naliato, M., Alamanni, F., Galanti, A., Fiore, G., Veglia, F., Tremoli, E., Biglioli, P., & Camera, M. (2005). Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery. The Journal of Thoracic and Cardiovascular Surgery, 130(2), 303-8.
Parolari A, et al. Increased Prothrombotic State Lasting as Long as One Month After On-pump and Off-pump Coronary Surgery. J Thorac Cardiovasc Surg. 2005;130(2):303-8. PubMed PMID: 16077391.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery. AU - Parolari,Alessandro, AU - Mussoni,Luciana, AU - Frigerio,Marta, AU - Naliato,Moreno, AU - Alamanni,Francesco, AU - Galanti,Andrea, AU - Fiore,Giuseppe, AU - Veglia,Fabrizio, AU - Tremoli,Elena, AU - Biglioli,Paolo, AU - Camera,Marina, PY - 2005/8/4/pubmed PY - 2005/10/21/medline PY - 2005/8/4/entrez SP - 303 EP - 8 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 130 IS - 2 N2 - OBJECTIVE: This study investigated whether the activation of coagulation, fibrinolysis, and endothelium occurring during the first postoperative month after on-pump coronary artery bypass surgery differs from that after off-pump coronary artery bypass grafting. METHODS: Thirty-five patients candidates to coronary surgery were randomized to undergo on-pump (n = 18) or off-pump (n = 17) coronary artery bypass grafting. Blood samples were collected before the intervention and to 1 month after surgery. RESULTS: Prothrombin fragment F1.2, thrombin-antithrombin complex, and D-dimer increased after surgery and were persistently higher than preoperative values as late as 30 postoperative days in both on- and off-pump groups; higher levels of these variables were detected after on-pump surgery relative to off-pump surgery only at the time point after termination of cardiopulmonary bypass (fragment F1.2 and thrombin-antithrombin complex) or from bypass end to 8 postoperative days (D-dimer). Fibrinogen levels decreased after surgery and then increased in parallel in both groups to 8 days after surgery. The von Willebrand factor level increased postoperatively in both groups and returned to baseline 30 days after surgery; it was higher after on-pump surgery from bypass end to 8 postoperative days. Soluble vascular cell adhesion molecule 1 was increased significantly from baseline in both groups 30 days after surgery, with no difference between groups. CONCLUSION: Patients undergoing off-pump surgery showed protection against activation of coagulation and fibrinolysis and against endothelial injury only during the intraoperative period; this was followed by the development of a prothrombotic pattern comparable to that of patients undergoing on-pump surgery lasting at least as late as 30 days after surgery. SN - 0022-5223 UR - https://www.unboundmedicine.com/medline/citation/16077391/Increased_prothrombotic_state_lasting_as_long_as_one_month_after_on_pump_and_off_pump_coronary_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S002252230401582X DB - PRIME DP - Unbound Medicine ER -