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[Thrombin-antithrombin complexes and F1+2 prothrombin fragment in coronary revascularization surgery. Relationship
J Rifón1, M T Collados, R Montes
1Servicio de Hematología, Facultad de Medicina, Universidad de Navarra, Pamplona.
Insights
Activation of the coagulation system is common after coronary bypass surgery. Preoperative thrombin-antithrombin complexes (TAT) may predict early graft occlusion in these patients.
Area of Science:
- Cardiovascular Surgery
- Hemostasis and Thrombosis
- Vascular Biology
Context:
- Aortocoronary bypass surgery is a critical procedure for managing coronary artery disease.
- Early graft occlusion remains a significant complication, impacting long-term patient outcomes.
- Understanding the mechanisms of graft failure is crucial for improving surgical success rates.
Purpose:
- To investigate the role of coagulation system activation in early graft occlusion following aortocoronary bypass.
- To assess the correlation between specific coagulation markers and the occurrence of thrombotic occlusion.
- To determine if preoperative coagulation status can predict postoperative graft patency.
Summary:
- This study analyzed 30 patients undergoing coronary revascularization, measuring thrombin-antithrombin complexes (TAT) and prothrombin fragment 1+2 (F1+2) levels.
- Postoperative levels of TAT and F1+2 significantly increased, irrespective of graft occlusion.
- Preoperative TAT levels were significantly higher in patients who developed thrombotic occlusion.
Impact:
- Coagulation system activation is a prominent feature in patients undergoing coronary revascularization.
- Preoperative measurement of TAT may serve as a valuable biomarker for predicting early graft occlusion.
- These findings could lead to improved patient stratification and targeted interventions to prevent graft failure.
Purpose:
To evaluate the possible role played by activation of the coagulation system in the early occlusion of grafts in patients subjected to aortocoronary bypass.
Patients And Methods:
This study includes 30 patients subjected to coronary revascularization surgery. The plasma rates of thrombin-anti-thrombin complexes (TAT) and 1+2 prothrombin fragments (F1+2) were measured before and after surgery. The studies were performed by enzyme immunoassay techniques. Selective angiography was performed in every patient on the 10th day after surgery. Descriptive statistics, Student's t test and Mann-Whitney U test were used for comparison of means ans statistical analysis.
Results:
Occlusive lesion was shown by angiography in 15 of the 30 patients. The TAT and F1+2 levels showed a statistically significant increase (p less than 0.001) along the postoperative period, without any correlation regarding the presence or absence of occlusion. The preoperative concentration of TAT was significantly higher in patients with thrombotic occlusion (p less than 0.05).
Conclusions:
1) Marked activation of the coagulation system is present in patients subjected to coronary revascularization surgery. 2) The pre-operative determination of TAT may be of value for predicting early graft occlusion.