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 journalArticlepeer-review

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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