Platelet function after coronary artery bypass grafting: is there a procoagulant activity after off-pump compared with on-pump surgery?
OBJECTIVE
After off-pump coronary artery bypass (OPCAB) haemostasis might be better preserved compared with on-pump coronary artery bypass grafting (CABG). The aim of this study was to investigate whether this possibly better preserved haemostasis results in a procoagulant activity of the platelets.


METHODS
Thirty patients were studied prospectively, 15 undergoing on-pump CABG and 15 undergoing OPCAB. Platelet function was evaluated four times within the first 24 h: preoperatively, postoperatively, 4 h and 1 day after surgery with a bedside whole blood clotting test.


RESULTS
A significant increase of platelet-activating-factor-induced platelet aggregation was observed postoperatively after OPCAB (p < 0.01). Only two patients did not reach preoperative values within 1 day postoperatively and four patients had a more than twofold increase. Platelet aggregation immediately after on-pump CABG was reduced to near half of preoperative values, but within 1 day postoperatively normal platelet aggregation was regained in half of the patients.


CONCLUSIONS
This study has mainly indicated that platelets after OPCAB were more easily activated in the early postoperative period. After CABG with cardiopulmonary bypass we found a temporary platelet dysfunction which seemed to be overcome within the first postoperative day.
Møller
C H
CH
Department of Cardiothoracic Surgery, Rigshospitalet, University of Copenhagen, Denmark. chm@stud.ku.dk
Steinbrüchel
D A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D001792:Blood Platelets / Q000502:physiology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010972:Platelet Activating Factor / Q000032:analysis*; D010974:Platelet Aggregation / Q000502:physiology; D010976:Platelet Count; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
D010972:Platelet Activating Factor