Sustained heparin effect contributes to reduced plasma thrombin generation capacity early after cardiac surgery.

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Radulovic, Vladimir,1969Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine (author)

Sustained heparin effect contributes to reduced plasma thrombin generation capacity early after cardiac surgery.

Article/chapterEnglish2012

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Elsevier BV,2012

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LIBRIS-ID:oai:gup.ub.gu.se/154720
https://gup.ub.gu.se/publication/154720URI
https://doi.org/10.1016/j.thromres.2011.12.025DOI

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Language:English

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Subject category:art swepub-publicationtype

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INTRODUCTION: Thrombin is a key component in the coagulation cascade, and impaired thrombin generation has been linked to increased bleeding after surgical procedures. The aim was to evaluate postoperative thrombin generation capacity in plasma after cardiac surgery, and its potential associations to activity of individual coagulation factors and heparin. MATERIAL AND METHODS: Forty-eight coronary artery bypass grafting patients were included in a prospective observational cohort study. Thrombin generation capacity was analysed in plasma with calibrated automated thrombogram with tissue factor as activator before (baseline), and 2h and 24h after surgery. In addition, plasma activity of coagulation factors II, V, VII, VIII, IX, X, XI, XIII, were determined. Heparin effect was assessed by anti-Xa activity, APTT and thrombin time. RESULTS: Thrombin generation was markedly reduced 2h after surgery compared to baseline. Peak levels decreased with median 74% (interquartile range 52-90), p<0.001, and endogenous thrombin generation potential decreased with 65% (43-86), p<0.001. Postoperative changes in endogenous thrombin generation potential correlated inversely to changes in anti-Xa activity (r=-0.51, p=0.010) and to changes in thrombin time (r=-0.51, p=0.009), but there were no correlations to changes in individual coagulation factor activity. CONCLUSIONS: A marked reduction in thrombin generation potential was observed in the early postoperative phase after cardiac surgery. The decrease was independent of reductions in individual coagulation factor activity but correlated to heparin effects. The results indicate that a sustained heparin effect contributes to the postoperative reduction in thrombin generation capacity.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Thrombin generation
Cardiac surgery
Heparin
Coagulation factors

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Hyllner, Monica,1964Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xhylmo (author)
Ternström, Lisa,1972Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine (author)
Karlsson, MartinGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences (author)
Bylock, Anders (author)
Hansson, Kenny M (author)
Baghaei, Fariba,1964Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xbagfa (author)
Jeppsson, Anders,1960Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xjepan (author)
Göteborgs universitetInstitutionen för medicin (creator_code:org_t)

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In:Thrombosis research: Elsevier BV130:5, s. 769-7741879-24720049-3848

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

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