Increased fibrinolysis and platelet activation in elderly patients undergoing coronary bypass surgery.
Reexploration for hemorrhage after cardiac surgery is associated with increased morbidity and mortality. Elderly cardiac surgical patients have an increased risk of excessive bleeding and reexploration. In the present study we investigated the perioperative hemostatic function in elderly patients compared with younger patients undergoing coronary artery bypass grafting. Twenty-five elderly (75 yr and older) and 25 younger (younger than 60 yr) patients were included in the study. Blood samples for the analysis of platelet counts, international normalized ratio, activated partial thromboplastin time, fibrinogen, d-dimer, antithrombin, prothrombin fragment 1 + 2, thrombin-antithrombin complex, plasmin inhibitor, neutrophil-activating peptide 2, and platelet-monocyte complexes were drawn preoperatively, 30 min, and 3 h postoperatively and approximately 20 h postoperatively. Elderly patients had an increased activation of the hemostatic system. In particular, elderly patients showed a more pronounced increase in fibrinolysis and platelet activation postoperatively compared with younger patients.
Pleym
Hilde
H
Department of Cardiothoracic Anesthesia and Intensive Care, St. Olav University Hospital, Trondheim, Norway. hilde.pleym@stolav.no
Wahba
Alexander
A
Videm
Vibeke
V
Asberg
Arne
A
Lydersen
Stian
S
Bjella
Lise
L
Dale
Ola
O
Stenseth
Roar
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation / Q000502:physiology; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology*; D010976:Platelet Count / Q000706:statistics & numerical data; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies