• Eur J Cardiothorac Surg · Mar 2012

    Hypercoagulability in patients undergoing coronary artery bypass grafting: prevalence, patient characteristics and postoperative outcome.

    • Sulman Rafiq, Pär Ingemar Johansson, Sisse Rye Ostrowski, Trine Stissing, and Daniel Andreas Steinbrüchel.
    • Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. sulman_raf@hotmail.com
    • Eur J Cardiothorac Surg. 2012 Mar 1;41(3):550-5.

    ObjectivesTo investigate the prevalence of preoperative hypercoagulability assessed by thromboelastography (TEG), to identify patient characteristics associated with hypercoagulability and to explore whether hypercoagulability is associated with a greater risk for myocardial infarction (MI), stroke and mortality 30 days after coronary artery bypass grafting (CABG) surgery.MethodsThis is a prospective, observational study of 200 consecutive CABG surgery patients. Hypercoagulability was defined as TEG maximum amplitude >69 mm.ResultsEighty-seven out of 200 (43.5%) CABG patients were TEG-hypercoagulable. In univariate regression analysis, age, female gender, hypertension, severe chronic obstructive pulmonary disease, platelet count and fibrinogen level were significantly associated with TEG-hypercoagulability. Multivariate regression analysis revealed higher age, platelet count and fibrinogen levels as variables independently associated with TEG-hypercoagulability. Thirty-day outcome data: MI (TEG-hypercoagulable 6.9% vs. TEG-normocoagulable 3.7%, NS), stroke (8.0 vs. 2.8%, NS) and mortality (4.6 vs. 0.9%, NS). There was a significant difference in 30-day combined event rate of MI, stroke and mortality (17.2 vs. 6.6%, P = 0.019). In univariate analysis, only female gender and TEG-hypercoagulability were significantly associated with 30-day combined event rate. In multivariate analysis, only female gender was significantly associated with 30-day outcome (P = 0.014), whereas TEG-hypercoagulability demonstrated a trend (P = 0.065).ConclusionsHypercoagulability identified by TEG was preoperatively found in 43.5% of CABG patients, and the findings of this study support the notion that TEG-hypercoagulable patients have a higher risk for a combination of thromboembolic complications and death after surgery.

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