Document Detail


Thrombophilic variables do not increase the generation or procoagulant activity of thrombin during cardiopulmonary bypass.
MedLine Citation:
PMID:  18222259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The generation of thrombin and its procoagulant activity are upregulated during cardiopulmonary bypass (CPB). Thrombophilia associates with increased basal thrombin generation and might therefore propagate thrombin generation during CPB. The objective of this study was to test whether preoperative thrombophilic variables associate with increased generation of thrombin or its procoagulant activity during and after CPB. METHODS: Comprehensive thrombophilia screening was performed in patients (n = 100) before elective coronary artery bypass grafting (CABG) with CPB. Markers of thrombin generation (prothrombin fragment F1+2), its procoagulant activity (soluble fibrin complexes), and a marker of fibrin degradation (D-dimer) were measured serially at eight time points before, during, and after CABG. RESULTS: Abnormal thrombophilia screening was common (44%). While patients with thrombophilic variables had higher preoperative prothrombin fragment F1+2 than others (median [interquartile range] 0.55 [0.34] vs 0.45 (0.21) nmol/L, p = 0.009) they did not have higher F1+2, D-dimer, or soluble fibrin complex levels during CPB or postoperatively than patients without thrombophilic variables. CONCLUSIONS: Preoperative thrombophilic variables do not associate with perioperative thrombin generation or its procoagulant activity in patients undergoing CABG. Our results do not support routine thrombophilia screening before CABG.
Authors:
Peter Raivio; Jari Petäjä; Anne Kuitunen; Riitta Lassila
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-28     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  536-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, Helsinki University Central Hospital, Helsinki, Finland. peter.raivio@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Analysis of Variance
Cardiopulmonary Bypass / methods*
Cohort Studies
Confidence Intervals
Coronary Artery Bypass / methods
Coronary Disease / surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Peptide Fragments / metabolism*
Postoperative Care
Preoperative Care / methods
Protein Precursors / metabolism*
Prothrombin / metabolism*
Risk Assessment
Statistics, Nonparametric
Survival Analysis
Thrombin / metabolism
Thrombophilia / complications,  diagnosis*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Peptide Fragments; 0/Protein Precursors; 72270-84-9/prothrombin fragment 1; 78768-79-3/prothrombin fragment 2; 9001-26-7/Prothrombin; EC 3.4.21.5/Thrombin
Comments/Corrections
Comment In:
Ann Thorac Surg. 2008 Feb;85(2):542   [PMID:  18222260 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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