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Activated Partial Thromboplastin Time and Mortality in Coronary Artery Bypass Grafting Patients

HuanRui Zhang1, Wen Tian1, Guoxian Qi1

  • 1Department of Geriatric Cardiology, The First Hospital of China Medical University, China.

Disease Markers
|September 28, 2022
PubMed

Insights

Preoperative activated partial thromboplastin time (APTT) levels can predict mortality risk in patients undergoing coronary artery bypass grafting (CABG). A longer APTT, specifically 44 seconds or more, is linked to a higher risk of death after CABG surgery.

Area of Science:

  • Cardiology
  • Medical Informatics
  • Surgical Outcomes

Background:

  • Assessing preoperative factors is crucial for predicting outcomes in patients undergoing coronary artery bypass grafting (CABG).
  • Activated partial thromboplastin time (APTT) is a routine coagulation test, but its prognostic value in CABG patients is not fully established.

Purpose of the Study:

  • To evaluate the prognostic significance of preoperative activated partial thromboplastin time (APTT) in patients undergoing coronary artery bypass grafting (CABG).
  • To determine if APTT can serve as an independent predictor of mortality in this patient population.

Main Methods:

  • Data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database, including 2,706 patients undergoing CABG.
  • Optimal cut-off value for APTT was determined using X-tile software; Cox proportional hazard models and Kaplan-Meier survival analysis were employed.
  • Propensity score matching (PSM) was utilized to ensure the robustness of the findings regarding APTT and mortality risk.

Main Results:

  • An optimal cut-off value of 44 seconds for preoperative APTT was identified for predicting 4-year mortality.
  • Patients with APTT ≥ 44 seconds exhibited a significantly higher risk of all-cause death, both before (HR 1.42) and after PSM (HR 1.47).
  • Elevated APTT levels correlated with lower 1-year and 4-year cumulative survival probabilities, and APTT improved the predictive accuracy of existing severity scores.

Conclusions:

  • Preoperative activated partial thromboplastin time (APTT) ≥ 44 seconds is associated with an increased risk of mortality in patients undergoing coronary artery bypass grafting (CABG).
  • APTT demonstrates potential as a valuable prognostic predictor for long-term outcomes in CABG patients.
Abstract

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