• Xiaojie Liu, Wenyuan Zhang, Naping Chen, Lijuan Wang, Sudena Wang, Yang Yu, and Hushan Ao.
• Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
• Ann. Thorac. Surg. 2020 Feb 1; 109 (2): 541-546.

BackgroundBleeding after cardiac surgery remains a challenge. Numerous studies suggest that higher level of C-reactive protein (CRP) increases cardiovascular risk. There is limited information revealing the association of preoperative CRP concentration and postoperative bleeding while undergoing on-pump coronary artery bypass grafting (CABG). This study aimed to investigate the relationship between preoperative CRP level and postoperative bleeding within 24 hours after CABG.MethodsData on 1055 patients accepting isolated primary CABG at Fuwai Hospital, Chinese Academy of Medical Sciences from September 2017 to July 2018 were recorded. Preoperative CRP concentration, laboratory coagulation parameters, intraoperative data, and postoperative bleeding volume within 24 hours after surgery were recorded. The primary endpoint was bleeding volume within 24 hours after surgery. We analyzed the correlation between bleeding volume within 24 hours after surgery and preoperative data with univariate and multiple linear regression.ResultsPreoperative CRP concentration (B = -0.094, P < .001), platelet count (B = -0.115, P < .01), thrombocytocrit (B = -0.127, P < .001), prothrombin time (B = 0.052, P < .01), and fibrinogen (B = -0.096, P < .01) were univariably correlated with postoperative bleeding volume. However preoperative CRP concentration (B = -0.089, P < .05) was an independent predictor of postoperative bleeding volume after multiple linear regression. Preoperative CRP concentration was also associated with body mass index (B = 0.068, P = .038), activated partial thromboplastin time (B = 0.089, P < .01), and fibrinogen (B = 0.519, P < .01) after multiple linear regression.ConclusionsOur findings suggested that preoperative CRP concentration independently correlated with postoperative bleeding volume within 24 hours and that it could be a new potential coagulation biomarker for patients undergoing CABG surgery.Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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