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Association between early postoperative coagulation activation and peri-operative myocardial ischaemia in patients

B W Böttiger1, S A Snyder-Ramos, W Lapp

  • 1Department of Anaesthesiology, University of Heidelberg, Germany.

Anaesthesia
|November 18, 2005
PubMed

Insights

Peri-operative myocardial ischemia in vascular surgery patients is linked to increased coagulation and fibrinolysis activation. This early activation correlates with peri-operative myocardial cell damage, especially in those with coronary artery disease history.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Hemostasis

Background:

  • Peri-operative myocardial ischemia is a significant risk in vascular surgery.
  • Understanding the link between coagulation, fibrinolysis, and myocardial damage is crucial.

Purpose of the Study:

  • To investigate the association between peri-operative myocardial ischemia and the activation of coagulation and endogenous fibrinolysis.
  • To explore the relationship between these hemostatic markers and myocardial cell damage.

Main Methods:

  • 50 patients undergoing vascular surgery were monitored using Holter and ECG.
  • Serial blood samples measured fibrin monomers, D-dimer, cardiac troponin T, and I.
  • Coagulation activation and endogenous fibrinolysis markers were assessed peri-operatively.

Main Results:

  • Patients with myocardial ischemia showed higher fibrin monomer and D-dimer levels.
  • Significant positive correlations were found between hemostatic markers and cardiac troponins.
  • Early postoperative activation of coagulation and fibrinolysis was observed.

Conclusions:

  • Early activation of coagulation and fibrinolysis is associated with peri-operative myocardial cell damage.
  • This association is particularly relevant in patients with coronary artery disease history undergoing vascular surgery.
  • Hemostatic activation may serve as an indicator of myocardial injury in this high-risk group.

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