Clinical Studies
Long Period and High Level of D-Dimer after Coronary Artery Bypass Grafting Surgery
2018 年 59 巻 1 号 p. 51-57
詳細
2018 年 59 巻 1 号 p. 51-57
Hyper-coagulation after off-pump coronary artery bypass grafting (OPCAB) is one of the main reasons for graft thrombosis. D-dimer is closely linked to the activation of coagulation. Few studies have reported the variation range and long-term abnormal coagulation after OPCAB in the Chinese population. Our study aimed to determine the characteristics and value of D-dimer after OPCAB.
In this prospective study, 265 patients who underwent OPCAB for the first time were recruited from 2011 to 2012. The D-dimer level of the patients was tested before surgery and on the 1st, 4th, and 14th day, and 1st, 2nd, and 3rd month after surgery. Clinical data in the perioperative period and during the one-year follow-up period were recorded.
D-dimer level increased from day 4 after OPCAB ([1321.9 ± 36.4] μg/L), peaked at 1 month ([2839.7 ± 101.4] μg/L), and decreased to the baseline ([370.3 ± 260.2] μg/L) 3 months after surgery. No death occurred, but 25 (10%) patients suffered recurrent angina in the one-year follow-up. They had significantly higher D-dimer level at one month after OPCAB than those of patients who did not suffer from angina. Preoperative ejection fraction <50% and D-dimer level >2915 μg/L at one month after surgery were significantly associated the recurrent angina.
After OPCAB, patients have a higher level of D-dimer. And this lasts for a long period (about 3 months). It may reflect a certain degree of hypercoagulable and hyperfibrinolytic state after OPCAB.
