Impact of diabetes mellitus on coagulation function before and after off-pump coronary artery bypass grafting

被引:8
作者
Wang, Dawei [1 ]
Liu, Yu [2 ]
Chen, Ziying [2 ]
Yang, Fei [3 ]
Zhang, Zhenining [1 ]
Wei, Yulei [1 ]
机构
[1] Hebei North Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Zhangjiakou 075000, Peoples R China
[2] Hebei Med Univ, Hosp 2, Dept Cardiac Surg, 215 Hepingxi Rd, Shijiazhuang 050000, Hebei, Peoples R China
[3] Hebei North Univ, Affiliated Hosp 1, Dept Med Imaging, Zhangjiakou 075000, Peoples R China
关键词
Coronary artery bypass grafting; off-pump coronary artery bypass grafting (OPCABG); thromboelastography (TEG); coagulation function; diabetes mellitus (DM); ON-PUMP; METAANALYSIS; SURGERY; FIBRINOLYSIS; ACTIVATION; DISEASE;
D O I
10.21037/jtd.2019.11.27
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: This study aims to explore the influence of off-pump coronary artery bypass grafting (OPCABG) on coagulation function and the effects of diabetes on coagulation function during OPCABG. Methods: Patients who met the inclusion and exclusion criteria were divided into two groups: diabetes mellitus (DM) and non-diabetes mellitus (NDM) groups. Thromboelastography (TEG) was tested at the following time points: T0, five days after aspirin and clopidogrel therapy, and before OPCABG; T1, returning to care unit after OPCABG; T2, 5 days after aspirin and clopidogrel therapy, and after OPCABG. Results: A total of 56 patients were involved. There were no deaths, or no early postoperative thrombotic events and abnormal bleeding after OPCABG. Intra-group comparison: Compared with T0, the R and K value decreased, while the a angle and MA value increased at T1 and T2, in both groups (P<0.05). A significantly statistical difference was found in the multiple comparison at T0, T1 and T2 (P<0.05). The results are as follows: the R value decreased at T1 and increased at T2, but the value remained less than that at T0. After the OPCABG, the K value gradually decreased, while the MA value and a angle gradually increased. Comparison between groups: T1: the R values were lower in the DM group, when compared to the NDM group (t=3.611, P=0.001). The differences in the MA, K and alpha angle were not statistically significant. T0 and T2: there were no statistically difference in the R, MA, K, alpha a angle and LY30 between the two groups (P>0.05). Conclusions: The coagulation function of patients was at a hypercoagulable state at the early stage after OPCABG. The coagulation function was affected by diabetes at the day of OPCABG. However, there was no statistical difference after 5 days of aspirin and clopidogrel therapy following OPCABG.
引用
收藏
页码:5517 / 5526
页数:10
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