Platelet function after coronary artery bypass grafting: is there a procoagulant activity after off-pump compared with on-pump surgery?

• Published in: Scandinavian cardiovascular journal : SCJ Vol. 37; no. 3; pp. 149 - 153
• Main Authors: Møller, C. H., Steinbrüchel, D. A.
• Format: Journal Article
• Language: English
• Published: Copenhagen Informa UK Ltd 01.01.2003; Oslo Taylor & Francis; Stockholm Scandinavian University Press
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood Coagulation; Blood Loss, Surgical - physiopathology; Blood Platelets - physiology; Cabg With Cpb; Cardiopulmonary Bypass - adverse effects; Cardiopulmonary Bypass - methods; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - methods; Coronary Artery Disease - blood; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Female; Follow-Up Studies; Hemostasis - physiology; Humans; Hypercoagulation; Male; Medical sciences; Middle Aged; Opcab; Perioperative Care; Platelet Activating Factor - analysis; Platelet Aggregation - physiology; Platelet Count; Platelet Function; Probability; Prospective Studies; Risk Assessment; Statistics, Nonparametric; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Survival Rate; Treatment Outcome; Human; Hypercoagulability; Treatment; Aortocoronary; Bypass; CABG with CPB; Surgery; Coronary artery; Platelet function; OPCAB; hypercoagulation
• ISSN: 1401-7431; 1651-2006
• DOI: 10.1080/14017430310001456

Objective--After off-pump coronary artery bypass (OPCAB) haemostasis might be better preserved compared with on-pump coronary artery bypass grafting (CABG). The aim of this study was to investigate whether this possibly better preserved haemostasis results in a procoagulant activity of the platelets. Design--Thirty patients were studied prospectively, 15 undergoing on-pump CABG and 15 undergoing OPCAB. Platelet function was evaluated four times within the first 24 h: preoperatively, postoperatively, 4 h and 1 day after surgery with a bedside whole blood clotting test. Results--A significant increase of platelet-activating-factor-induced platelet aggregation was observed postoperatively after OPCAB (p < 0.01). Only two patients did not reach preoperative values within 1 day postoperatively and four patients had a more than twofold increase. Platelet aggregation immediately after on-pump CABG was reduced to near half of preoperative values, but within 1 day postoperatively normal platelet aggregation was regained in half of the patients. Conclusion--This study has mainly indicated that platelets after OPCAB were more easily activated in the early postoperative period. After CABG with cardiopulmonary bypass we found a temporary platelet dysfunction which seemed to be overcome within the first postoperative day.