Premium
Association between early postoperative coagulation activation and peri‐operative myocardial ischaemia in patients undergoing vascular surgery
Author(s) -
Böttiger B. W.,
SnyderRamos S. A.,
Lapp W.,
Motsch J.,
Aulmann M.,
Schweizer M.,
Layug E. L.,
Martin E.,
Mangano D. T.
Publication year - 2005
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04328.x
Subject(s) - medicine , fibrinolysis , myocardial infarction , cardiology , ischemia , fibrin , troponin , d dimer , troponin t , coagulation , anesthesia , immunology
Summary We investigated the association of peri‐operative myocardial ischaemia with activation of coagulation and endogenous fibrinolysis in patients undergoing vascular surgery. In 50 patients, continuous Holter monitoring was performed to assess peri‐operative myocardial ischaemia and 12‐lead electrocardiography was recorded preoperatively and 72 h postoperatively to assess myocardial infarction. Serial blood samples were drawn peri‐operatively to determine the concentrations of fibrin monomers (for activation of coagulation), d ‐dimer (for endogenous fibrinolysis) and cardiac troponin T and I. Patients with myocardial ischaemia showed higher concentrations of fibrin monomers at 48 h, and higher concentrations of d ‐dimer preoperatively and at 24 and 48 h postoperatively. In patients with peri‐operative myocardial ischaemia, strong positive correlations were observed between fibrin monomer and d ‐dimer concentrations at 15 min and 4 h postoperatively, and cardiac troponins at 15 min and at 4, 24, 48 and 72 h postoperatively. Early postoperative activation of coagulation and fibrinolysis is associated with peri‐operative myocardial cell damage among patients who are at risk for, or have a history of, coronary artery disease plus peri‐operative myocardial ischaemia.