Changes of coagulation and platelet function in patients undergoing coronary ar-tery bypass grafting

Cui Hua-nan; Wu Ming-ying; Zhou Zi-qiang; Wang Yan-jun

doi:10.13498/j.cnki.chin.j.ecc.2014.03.11

Abstract：Objective This study was designed to evaluate the changes of coagulation and platelet function in patients under-going coronary artery bypass grafting with or without cardiopulmonary bypass ( CPB) by thromboelastography ( TEG) and platelet map-ping. Methods Between April 2012 and December 2012, 48 consecutive patients received coronary artery bypass. They were random-ly assigned to two groups. 20 underwent off-pump coronary artery bypass ( OPCAB group) and 28 underwent coronary artery bypass grafting ( CABG) with CPB ( CCABG group) . Blood samples were collected at 5 minutes before heparinization and 10 minutes after heparin neutralization. Coagulation function was studied with TEG and platelet mapping assay, activated clotting time ( ACT) and blood routine analysis. Postoperative blood loss and transfusion were recorded. Results There were no significant differences in TEG assay and ACT between groups before heparinization. After heparinization, R-time, K-time and α-angle were insignificantly different be-tween the two groups, while maximal amplitude and inhibition of platelet were significantly different. Furthermore, R-time, K-time was slightly increased, andα-angle (α) was slightly decreased after neutralization, but maximal amplitude was significantly lower and inhibition of platelet was significantly increased in the CCABG groups ( P<0.05) . Postoperative blood loss and transfusion in OPCAB group were both lower than those in CCABG group. Conclusion Impairment of platelet function contributes primarily to the postopera-tive dysfunction of coagulation. Compared with CCABG, OPCAB is in favor of protection of platelet function and coagulation, helping lower postoperative bleeding and transfusion volume.