Coagulation abnormalities in patients undergoing myocardial revascularization.
One hundred patients were screened for hypercoagulability preoperatively and on the third, seventh, tenth, fourteenth, and twenty-first days postoperatively. Patients found to have hypercoagulability were treated with heparin, aspirin, and Coumadin. When the abnormality was present preoperatively, treatment was continued for the duration of the patient's life. Those patients in whom abnormalities developed postoperatively were given anticoagulants until cardiac catheterization 6 months following their operation. Twenty-four of the 100 patients had no coagulation abnormalities preoperatively or postoperatively. Fifteen patients were found to have abnormality prior to operation. Their predominant abnormality was low antithrombin III activity. Sixty-one patients became hypercoagulable postoperatively. Predominant abnormality in this group of patients was increased thrombin generation and increased platelet adhesiveness. Evaluation of patients in this study group revealed a decrease in the incidence of pulmonary embolism, an increase in the patency of vein grafts, and the elimination of anticoagulant therapy in 24 percent of the patients.
D000925:Anticoagulants / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000188:drug therapy*; D003120:Colorado; D001026:Coronary Artery Bypass; D006801:Humans; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000453:epidemiology; D012306:Risk; D013927:Thrombosis / Q000209:etiology; D014182:Transplantation, Autologous; D014680:Veins / Q000637:transplantation
D000925:Anticoagulants