Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery

Alessandro Parolari, Luciana Mussoni, Marta Frigerio, Moreno Naliato, Francesco Alamanni, Andrea Galanti, Giuseppe Fiore, Fabrizio Veglia, Elena Tremoli, Paolo Biglioli, Marina Camera

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)303-308
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume130
Issue number2
DOIs
Publication statusPublished - Aug 2005

Fingerprint

Ambulatory Surgical Procedures
Coronary Artery Bypass
Fibrinolysis
Intraoperative Period
Off-Pump Coronary Artery Bypass
Vascular Cell Adhesion Molecule-1
von Willebrand Factor
Prothrombin
Cardiopulmonary Bypass
Fibrinogen
Endothelium
Wounds and Injuries
fibrin fragment D
antithrombin III-protease complex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery. / Parolari, Alessandro; Mussoni, Luciana; Frigerio, Marta; Naliato, Moreno; Alamanni, Francesco; Galanti, Andrea; Fiore, Giuseppe; Veglia, Fabrizio; Tremoli, Elena; Biglioli, Paolo; Camera, Marina.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 130, No. 2, 08.2005, p. 303-308.

Research output: Contribution to journalArticle

@article{b951077783544a868520d32e4de51a2f,
title = "Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery",
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.",
author = "Alessandro Parolari and Luciana Mussoni and Marta Frigerio and Moreno Naliato and Francesco Alamanni and Andrea Galanti and Giuseppe Fiore and Fabrizio Veglia and Elena Tremoli and Paolo Biglioli and Marina Camera",
year = "2005",
month = "8",
doi = "10.1016/j.jtcvs.2004.11.002",
language = "English",
volume = "130",
pages = "303--308",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "2",

}

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

Y1 - 2005/8

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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=23044486376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23044486376&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2004.11.002

DO - 10.1016/j.jtcvs.2004.11.002

M3 - Article

C2 - 16077391

AN - SCOPUS:23044486376

VL - 130

SP - 303

EP - 308

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 2

ER -