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Hypercoagulability in relation to coronary artery bypass graft patency and clinical outcome

Mette Zacho1, Sulman Rafiq, Henning Kelbæk

  • 1Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. jmzacho@gmail.com

Scandinavian Cardiovascular Journal : SCJ
|December 5, 2012
PubMed

Insights

Pre-surgical hypercoagulability in coronary artery bypass graft (CABG) patients, identified by thrombelastography (TEG), increases thrombembolic event risk. However, this hypercoagulability does not impact bypass graft patency after surgery.

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Diagnostic Medicine

Background:

  • Hypercoagulability, assessed via thrombelastography (TEG), is linked to thrombotic events in patients undergoing coronary artery bypass graft (CABG) surgery.
  • The relationship between pre-surgical TEG status, graft patency, and post-CABG thrombotic events requires further investigation.

Purpose of the Study:

  • To investigate the association between pre-surgical TEG status and graft patency post-CABG.
  • To determine if pre-surgical TEG status predicts major adverse cardiovascular and cerebral events (MACCE) after CABG.

Main Methods:

  • 124 patients undergoing CABG were categorized into TEG-hypercoagulable and TEG-normocoagulable groups based on pre-surgical thrombelastography.
  • Graft patency was evaluated using multidetector computed tomography (MDCT) three months post-surgery.
  • Major adverse cardiovascular and cerebral events (MACCE) were monitored for a median of 7 months.

Main Results:

  • No significant difference in bypass graft occlusion rates was observed between the hypercoagulable (21/186) and normocoagulable (18/173) groups.
  • The incidence of MACCE was significantly higher in the TEG-hypercoagulable group (30%) compared to the TEG-normocoagulable group (9%).

Conclusions:

  • Pre-surgical hypercoagulability identified by TEG in CABG patients is associated with an elevated risk of post-operative thrombotic events.
  • This hypercoagulability does not appear to negatively affect coronary bypass graft patency.
Abstract

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