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Fibrinogen and fibrin degradation products in patients undergoing open-heart surgery
J Rifón1, J Fernández, J A Páramo
1University Clinic, University of Navarra, Pamplona, Spain.
Insights
Open-heart surgery patients showed increased fibrinogen and fibrin degradation products (FgDP and FbDP). Fibrinolysis was more significant than fibrinogenolysis post-surgery, indicating important pathophysiological implications.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Biochemistry
Background:
- Cardiopulmonary bypass (CPB) is a critical procedure in open-heart surgery.
- Understanding the hemostatic changes following CPB is crucial for patient management.
- Fibrinogen and fibrin degradation products (FgDP and FbDP) are key markers of coagulation and fibrinolysis.
Purpose of the Study:
- To quantify FgDP and FbDP levels in patients undergoing CPB for valvular heart disease and aorto-coronary bypass surgery.
- To compare the post-operative changes in FgDP and FbDP between the two surgical groups.
- To elucidate the relative roles of fibrinogenolysis and fibrinolysis after open-heart surgery.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was employed to measure FgDP and FbDP.
- Specific monoclonal antibodies were used for precise quantification.
- Blood samples were collected pre-operatively and on post-operative days 1 and 5.
Main Results:
- Both FgDP and FbDP levels significantly increased post-operatively in all patients (P < 0.01 and P < 0.001, respectively).
- FbDP levels were notably higher on post-operative days 1 and 5 compared to baseline.
- Patients with valvular heart disease exhibited higher FbDP levels than coronary patients on post-operative day 1 (P < 0.01).
Conclusions:
- Fibrinolysis plays a more dominant role than fibrinogenolysis after open-heart surgery.
- Elevated FbDP suggests significant activation of the fibrinolytic system post-CPB.
- These findings have potential pathophysiological implications for managing patients after cardiac surgery.
Abstract:
We have determined fibrinogen and fibrin degradation products (FgDP and FbDP respectively) by an ELISA method using specific monoclonal antibodies in 100 patients undergoing cardiopulmonary bypass (CPB) for valvular heart disease and in 60 patients undergoing aorto-coronary bypass surgery. Blood samples were taken pre-operatively and on post-operative days 1 and 5. Post-operative evolution was similar in both patient groups, with a significant increase in FgDP on post-operative days 1 and 5 with respect to baseline value (P less than 0.01). FbDP were also significantly higher on post-operative days 1 and 5 (P less than 0.001), especially the day after surgery in patients with valvular disease as compared with coronary patients (P less than 0.01). Our results indicate that fibrinolysis is more important than fibrinogenolysis after open-heart surgery, which may have pathophysiological implications.