| Thrombin generation during reperfusion after coronary artery bypass surgery associates with postoperative myocardial damage. | |
| | |
MedLine Citation:
|
PMID: 16839349 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Cardiopulmonary bypass and coronary artery bypass grafting (CABG) result in significant thrombin generation and activation of fibrinolysis. Thrombin contributes to myocardial ischemia-reperfusion injury in animal studies, but the role of thrombin in myocardial damage after CABG is unknown. OBJECTIVES: We measured thrombin generation and fibrin turnover during reperfusion after CABG to evaluate their associations with postoperative hemodynamic changes and myocardial damage. METHODS: One hundred patients undergoing primary, elective, on-pump CABG were prospectively enrolled. Plasma prothrombin fragment F(1+2) and D-dimer were measured preoperatively and at seven time points thereafter. Mass of the Mb fraction of creatine kinase (Ck-Mbm) and troponin T (TnT) were measured on the first postoperative day. RESULTS: Reperfusion induced an escalation of thrombin generation and fibrin turnover despite full heparinization. F(1+2) during early reperfusion associated with postoperative pulmonary vascular resistance index. F(1+2) at 6 h after protamine administration correlated with Ck-Mbm (r = 0.40, P < 0.001) and TnT (r = 0.44, P < 0.001) at 18 h postoperatively. Patients with evidence of myocardial damage (highest quintiles of plasma Ck-Mbm and TnT) had significantly higher F(1+2) during reperfusion than others (P < 0.002). Logistic regression models identified F(1+2) during reperfusion to independently associate with postoperative myocardial damage (odds ratios 2.5-4.4, 95% confidence intervals 1.04-15.7). CONCLUSIONS: Reperfusion caused a burst in thrombin generation and fibrin turnover despite generous heparinization. Thrombin generation during reperfusion after CABG associated with pulmonary vascular resistance and postoperative myocardial damage. |
| | |
Authors:
|
P Raivio; A Kuitunen; R Suojaranta-Ylinen; R Lassila; J Petäjä |
Related Documents
:
|
1417279 - Risk analysis of operative intervention for failed coronary angioplasty. 2252769 - Hemopump support for the failing heart. 10948459 - Coping strategies, life style changes, and pessimism after open-heart surgery. 11111139 - Effects of spinal cord stimulation and coronary artery bypass grafting on myocardial is... 2979109 - Coronary artery bypass grafting within 24 hours after intracoronary streptokinase throm... 20487339 - Low-risk profile for malignant ventricular arrhythmias and sudden cardiac death after s... 8679239 - Transesophageal echocardiographic evaluation of the morphologic and hemodynamic cardiac... 3829489 - The relationship of ventricular arrhythmias to the angiographically and scintigraphical... 15534059 - Reduced oxidative metabolic response in dysfunctional myocardium with preserved glucose... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of thrombosis and haemostasis : JTH Volume: 4 ISSN: 1538-7933 ISO Abbreviation: J. Thromb. Haemost. Publication Date: 2006 Jul |
Date Detail:
|
Created Date: 2006-07-14 Completed Date: 2006-10-06 Revised Date: 2006-11-20 |
Medline Journal Info:
|
Nlm Unique ID: 101170508 Medline TA: J Thromb Haemost Country: England |
Other Details:
|
Languages: eng Pagination: 1523-9 Citation Subset: IM |
Affiliation:
|
Department of Cardiothoracic Surgery, Helsinki University Central Hospital, FIN-00029 HUS, Helsinki, Finland. peter.raivio@hus.fi |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Coronary Artery Bypass / adverse effects* Female Fibrin / metabolism Heparin / therapeutic use Humans Male Middle Aged Myocardial Ischemia / diagnosis*, etiology Postoperative Complications / etiology Prospective Studies Reperfusion Injury / complications* Thrombin / biosynthesis* |
| Chemical | |
Reg. No./Substance:
|
9001-31-4/Fibrin; 9005-49-6/Heparin; EC 3.4.21.5/Thrombin |
| Comments/Corrections | |
Erratum In:
|
J Thromb Haemost. 2006 Nov;4(11):2519 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Clinical probability and alveolar dead space measurement for suspected pulmonary embolism in patient...
Next Document: Circulating activated protein C is reduced in young survivors of myocardial infarction and inversely...