Inflammatory response and platelet activation after off-pump coronary artery bypass surgery

• Published in: Scandinavian cardiovascular journal : SCJ Vol. 40; no. 1; pp. 43 - 48
• Main Authors: Aljassim, Obaid, Karlsson, Martin, Wiklund, Lars, Jeppsson, Anders, Olsson, Per, Berglin, Eva
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 2006; Taylor & Francis
• Subjects: Aged; analysis; beta-Thromboglobulin; beta-Thromboglobulin - biosynthesis; biosynthesis; blood; CABG; Complement C3a; Complement C3a - biosynthesis; Coronary Artery Bypass; Coronary Artery Bypass, Off-Pump; Female; Fibrinogen; Fibrinogen - analysis; Heart Diseases; Heart Diseases - blood; Heart Diseases - immunology; Heart Diseases - surgery; Hematocrit; Hemostasis; Humans; immunology; Inflammatory response; Kirurgi; Leukocyte Elastase; Leukocyte Elastase - blood; Male; Middle Aged; Off-Pump; Platelet Activation; platelet function; Postoperative Hemorrhage; Postoperative Hemorrhage - blood; Postoperative Hemorrhage - immunology; Postoperative Period; Surgery
• ISSN: 1401-7431; 1651-2006
• DOI: 10.1080/14017430500381307

Background. Cardiac surgery induces a systemic inflammatory activation and alterations in the hemostatic cascade. The responses contribute to postoperative complications but may also have protective effects. We investigated the relationship between inflammation, hemostasis and bleeding after off-pump coronary artery bypass surgery (OPCAB). Methods. Ten OPCAB patients were included in a prospective descriptive study. Selected markers of inflammation (IL-6, IL-8, PMN-elastase, C3a, and SC5b-9), and hemostasis (platelet count, -thromboglobulin, anti-thrombin, D-dimer and fibrinogen) were measured before and immediately after surgery. Postoperative bleeding was registered. Results. Inflammatory variables did not alter significantly during surgery while -thromboglobulin concentrations increased and anti-thrombin and fibrinogen decreased. There were significant postoperative correlations between PMN-elastase and -thromboglobulin (r = 0.82, p = 0.004), between PMN-elastase and fibrinogen (r = 0.69, p = 0.03) and between C3a and -thromboglobulin (r = 0.71, p = 0.02). In addition, there were significant inverse correlations between postoperative bleeding and pre- and postoperative fibrinogen levels (r = − 0.76, p = 0.011 and r = − 0.84, p = 0.002 respectively), between bleeding and postoperative -thromboglobulin levels (r = − 0.66, p = 0.04) and between bleeding and postoperative PMN-elastase (r = − 0.75, p = 0.01). Conclusions. The results give further evidence for an association between the inflammatory response and hemostasis after cardiac surgery.