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Higher Preoperative Plasma Thrombin Potential in Patients Undergoing Surgery for Aortic Stenosis Compared to Surgery

Axel Dimberg1, Ulrica Alström1, Elisabeth Ståhle1

  • 11 Section of Thoracic Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|May 18, 2018
PubMed

Insights

Patients with severe aortic stenosis show increased plasma thrombin potential before surgery compared to coronary artery disease patients. This preoperative hemostasis marker did not predict postoperative bleeding in elective cardiac surgery patients.

Area of Science:

  • Cardiology
  • Hematology
  • Surgical Hemostasis

Background:

  • Aortic stenosis (AS) and coronary artery disease (CAD) can impact coagulation and bleeding during cardiac surgery.
  • Preoperative assessment of hemostasis is crucial for managing surgical bleeding risk.

Purpose of the Study:

  • To compare preoperative global hemostasis assays in patients with severe AS versus CAD.
  • To determine if these assays predict postoperative bleeding after elective cardiac surgery.

Main Methods:

  • Calibrated automated thrombogram (CAT) and rotational thromboelastometry (ROTEM) were used to assess hemostasis.
  • Evaluated 103 patients with severe AS and 68 patients with stable CAD undergoing elective surgery.

Main Results:

  • Patients with AS exhibited significantly higher plasma thrombin potential (thrombin peak and endogenous thrombin potential) than CAD patients (P < .001).
  • Thromboelastometry differences between groups did not persist after adjusting for baseline characteristics.
  • Postoperative bleeding showed no significant relationship with plasma thrombin potential but a weak association with thromboelastometry (R² = .064, P = .001).

Conclusions:

  • Severe AS patients present with elevated preoperative plasma thrombin potential compared to CAD patients.
  • Plasma thrombin potential is not a reliable predictor of postoperative bleeding in this surgical cohort.

Keywords:
bleedinghemostasisin vitro diagnostic systems

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