title: Hypercoagulability in relation to coronary artery bypass graft patency and clinical outcome.
abstract: OBJECTIVE
  Hypercoagulability evaluated with thrombelastography (TEG) has been reported to be associated to thrombembolic events in patients undergoing coronary artery bypass graft surgery (CABG). The objective of this study was to test the hypothesis that graft patency and post-CABG thrombembolic events are related to the pre-surgical TEG status.
  
  
  METHODS
  124 patients scheduled for CABG were matched according to mean age, gender and mean left ventricular ejection fraction in two groups defined by their pre-surgical TEG status (TEG-hypercoagulable and TEG-normocoagulable). Three months after the operation graft patency was assessed with multidetector computed tomography (MDCT). Major adverse cardiovascular and cerebral events (MACCE) were recorded for a median period of 7 months (range 3 to 37 months) after CABG.
  
  
  RESULTS
  A total of 359 grafts were analyzed, 186 in TEG-hypercoagulable and 173 in TEG-normocoagulable patients. Frequency of bypass graft occlusion was not significantly different between the two groups (TEG-hypercoagulable = 21 and TEG-normocoagulable = 18, p = 0.9). The number of MACCE was significantly higher in the TEG-hypercoagulable compared to the TEG-normocoagulable group (TEG-hypercoagulable = 30% and TEG-normocoagulable = 9% p = 0.004).
  
  
  CONCLUSIONS
  Hypercoagulability, as evaluated by TEG in patients undergoing CABG is associated with an increased risk of post-surgical thrombembolic events, however not accompanied by augmented coronary bypass graft failure.
authors.affiliation: Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. jmzacho@gmail.com
authors.forename: Mette
authors.initials: M
authors.lastname: Zacho
authors.forename: Sulman
authors.initials: S
authors.lastname: Rafiq
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.forename: Pär I
authors.initials: PI
authors.lastname: Johansson
authors.forename: Michael Bachmann
authors.initials: MB
authors.lastname: Nielsen
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Steinbrüchel
authors.forename: Klaus Fuglsang
authors.initials: KF
authors.lastname: Kofoed
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D018570:Risk Assessment; D012307:Risk Factors; D013916:Thrombelastography / Q000379:methods / Q000401:mortality; D019851:Thrombophilia / Q000150:complications / Q000209:etiology*; D016896:Treatment Outcome; D014654:Vascular Patency