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Impact of arterial procedures on coagulation and fibrinolysis - a pilot study
Polok, Kamil Jurand; Górka, Jacek; Fronczek, Jakub; Górka, Karolina; Kaczmarek, Bogusz; Iwaniec, Teresa; Iwaszczuk, Pawel; Musial, Jacek; Szczeklik, Wojciech.
  • Polok, Kamil Jurand; Jagiellonian University Medical College. Department of Intensive Care and Perioperative Medicine. Kraków. PL
  • Górka, Jacek; Jagiellonian University Medical College. Department of Intensive Care and Perioperative Medicine. Kraków. PL
  • Fronczek, Jakub; Jagiellonian University Medical College. Department of Intensive Care and Perioperative Medicine. Kraków. PL
  • Górka, Karolina; Jagiellonian University Medical College. Department of Medicine. Kraków. PL
  • Kaczmarek, Bogusz; Jagiellonian University Medical College. Department of Intensive Care and Perioperative Medicine. Kraków. PL
  • Iwaniec, Teresa; Jagiellonian University Medical College. Department of Medicine. Kraków. PL
  • Iwaszczuk, Pawel; Jagiellonian University Medical College. Department of Medicine. Kraków. PL
  • Musial, Jacek; Jagiellonian University Medical College. Department of Medicine. Kraków. PL
  • Szczeklik, Wojciech; Jagiellonian University Medical College. Department of Medicine. Kraków. PL
Rev. bras. cir. cardiovasc ; 34(3): 327-334, Jun. 2019. tab, graf
Article in English | LILACS | ID: biblio-1013461
ABSTRACT
Abstract

Objective:

The main goal of our study was to assess the impact of vascular procedures on the activity of hemostatic and fibrinolytic pathways.

Methods:

We enrolled 38 patients with ≥ 45 years old undergoing surgery for abdominal aortic aneurysm or peripheral artery disease under general or regional anesthesia and who were hospitalized at least one night after the procedure. Patients undergoing carotid artery surgery and those who had acute bypass graft thrombosis, cancer, renal failure defined as estimated glomerular filtration rate < 30 ml/min/1.73m2, venous thromboembolism three months prior to surgery, or acute infection were excluded from the study. We measured levels of markers of hemostasis (factor VIII, von Willebrand factorristocetin cofactor [vWFCoR], antithrombin), fibrinolysis (D-dimer, tissue plasminogen activator [tPA], plasmin-antiplasmin complexes), and soluble cluster of differentiation 40 ligand (sCD40L) before and 6-12h after vascular procedure.

Results:

Significant differences between preoperative and postoperative levels of factor VIII (158.0 vs. 103.3, P<0.001), antithrombin (92.1 vs. 74.8, P<0.001), D-dimer (938.0 vs. 2406.0, P=0.005), tPA (10.1 vs. 12.8, P=0.002), and sCD40L (9092.9 vs. 1249.6, P<0.001) were observed. There were no significant differences between pre- and postoperative levels of vWFCoR (140.6 vs. 162.8, P=0.17) and plasmin-antiplasmin complexes (749.6 vs. 863.7, P=0.21).

Conclusion:

Vascular surgery leads to significant alterations in hemostatic and fibrinolytic systems. However, the direction of these changes in both pathways remains unclear and seems to be different depending on the type of surgery. A study utilizing dynamic methods of coagulation and fibrinolysis assessment performed on a larger population is warranted.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Vascular Surgical Procedures / Blood Coagulation / Aortic Aneurysm, Abdominal / Peripheral Arterial Disease / Fibrinolysis Type of study: Etiology study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2019 Type: Article Affiliation country: Poland Institution/Affiliation country: Jagiellonian University Medical College/PL

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Full text: Available Index: LILACS (Americas) Main subject: Vascular Surgical Procedures / Blood Coagulation / Aortic Aneurysm, Abdominal / Peripheral Arterial Disease / Fibrinolysis Type of study: Etiology study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2019 Type: Article Affiliation country: Poland Institution/Affiliation country: Jagiellonian University Medical College/PL