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Published on: September 15, 2023
Effects of coronary artery by-pass grafting on haemostatic factors
Piotr Lisowski1, Jolanta Małyszko, Ryszard Jackowsk
1Department of Cardiac Surgery, Medical Academy, Białystok, Poland.
Insights
Coronary artery bypass grafting (CABG) increases hypercoagulability in patients with coronary artery disease (CAD). The procedure significantly elevates von Willebrand factor (vWF), indicating endothelial injury from extracorporeal circulation.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Surgical Research
Background:
- Atherogenesis involves endothelial injury, leading to alterations in humoral and secretion functions.
- The hemostatic system is crucial in the development of atherosclerosis and acute coronary syndromes.
Purpose of the Study:
- To evaluate the impact of coronary artery bypass grafting (CABG) on specific hemostatic factors in patients with stable coronary artery disease (CAD).
Main Methods:
- The study included 45 patients undergoing CABG and 33 healthy controls.
- Measurements of von Willebrand factor (vWF), thrombin-antithrombin complexes (TAT), and prothrombin fragments (F1+2) were taken pre-CABG and at 3 days, 7 days, and 3 months post-CABG.
Main Results:
- Patients undergoing CABG exhibited significantly higher levels of vWF, TAT, and F1+2 compared to controls.
- vWF levels were notably elevated 3 and 7 days after CABG compared to baseline.
Conclusions:
- Patients with CAD undergoing CABG experience a state of hypercoagulability.
- The use of extracorporeal circulation during CABG results in significant endothelial injury, evidenced by increased vWF levels.
Background:
Atherogenesis is triggered by functional or structural endothelial injury which leads to humoral and secretion alterations. The haemostatic system plays a significant role in the development of atherosclerosis and its complications, especially acute coronary syndromes.
Aim:
To assess the effects of coronary artery by-pass grafting (CABG) on some haemostatic factors in patients with stable coronary artery disease (CAD).
Methods:
The study group consisted of 45 patients (11 females, 34 males, mean age 60.4+/-9.4 years, range 35-75 years). Endothelial function marker - von Willebrand factor (vWF), and thrombin generation parameters - thrombin-antithrombin complexes (TAT) and prothrombin fragments - F1+2 were measured before as well as 3 days, 7 days and 3 months after CABG. The control group consisted of 33 healthy volunteers (17 females, 16 males, mean age 48.8+/-17.2 years).
Results:
Serum concentration of vWF as well as TAT and F1+2 levels were significantly higher in the CABG group than in controls. Compared with baseline values, the vWF levels were significantly higher 3 and 7 days after CABG.
Conclusions:
There is a hypercoagulability state in patients with CAD who undergo CABG. The use of extracorporeal circulation causes a significant increase in the vWF level which suggests a marked endothelial injury caused by CABG procedure.
