Changes in activated partial thromboplastin time and international normalised ratio after on-pump and off-pump surgical revascularization of the heart

Čeke, Lejla Selimović; Imamović, Semir; Ljuca, Farid; Jerkić, Z; Imamović, Goran; Hadžimešić, Munevera; Pojskić, Aida; Kovčić, Jasmina

doi:10.17305/bjbms.2014.2265

Cited by 4 publications

(2 citation statements)

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“…First, it appears that not only amiodarone injection, but also cardiac surgery can affect the anticoagulant effect of warfarin. Previous studies have suggested that the PT-INR values in patients who underwent cardiac surgeries were increased after surgery compared with the values before surgery [ 22 ]. In our study, although the values of PT-INR/dose were not significantly different between before and after surgery without administration of amiodarone, the status after cardiac surgery individually can be different.…”

Section: Discussionmentioning

confidence: 99%

Interaction between warfarin and short-term intravenous amiodarone in intensive care unit patients after cardiac surgery

Takase

Ikesue

Tohi

et al. 2018

J Pharm Health Care Sci

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BackgroundAmiodarone and warfarin are sometimes administered immediately after cardiac surgery. Although the interaction between long-term oral amiodarone and warfarin has been reported, the interaction between warfarin and short-term intravenous amiodarone has not been reported. In this study, we investigated the effect of short-term intravenous amiodarone on the anticoagulant effect of warfarin in patients who underwent cardiac surgery.MethodsWe retrospectively reviewed the medical records of 11 patients who received oral warfarin before and after cardiac surgery, and loading doses of 125–150 mg or a 750 mg continuous infusion of amiodarone, or both in the intensive care unit (ICU) within 5 days after the surgery between July 2011 and January 2017. The prothrombin time-international normalized ratio (PT-INR)/daily warfarin dose (PT-INR/dose) was used as an indicator of anticoagulant effect. The values before surgery were considered as the baseline.ResultsThe PT-INR and PT-INR/dose values were elevated in 7 and 10 patients, respectively, after amiodarone administration. The mean PT-INR values were not significantly different before and after amiodarone administration (2.13 ± 0.58 vs 2.29 ± 0.50, respectively, p = 0.643). In contrast, the mean PT-INR/dose values were significantly elevated after the administration of amiodarone (0.93 ± 0.46 vs 1.54 ± 0.63, respectively, p = 0.002).ConclusionsShort-term intravenous amiodarone enhanced the anticoagulant effect of warfarin in patients admitted to the ICU after cardiac surgery. We suggest that the dose of warfarin should be carefully adjusted for a few days after cardiac surgery if intravenous amiodarone is coadministered.

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Section: Discussionmentioning

confidence: 99%

Interaction between warfarin and short-term intravenous amiodarone in intensive care unit patients after cardiac surgery

Takase

Ikesue

Tohi

et al. 2018

J Pharm Health Care Sci

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“…The leading cause of death worldwide, especially in developed countries, is coronary artery disease (CAD) [ 1 - 4 ]. The etiology of CAD is atherosclerosis, which obstructs coronary arteries that supply oxygen and nutrition to the heart muscle [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Milutinović

Zorc-Pleskovič

2020

Bosn J of Basic Med Sci

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The patency of the vein graft in coronary artery bypass grafting could be dependent on the conventional open (vsO) or endoscopic (vsE) harvesting and on the hypoxic damage of endothelial cells. We aimed to evaluate both surgical techniques according to endothelial loss that occurs in the time between harvesting and implantation. Twenty-six saphenous veins were divided into vsO (n = 16) and vsE (n = 10) group. Three samples were taken from each vein. The first sample was taken after removal, the second before implantation of the distal part, and the third before the implantation of the proximal part, and they were stained with HE, Movat, and immunohistochemically with CD31. A significant loss of endothelial cells within both groups was found at the time of implantation of the distal and the proximal part of the vein graft compared to the endothelial cells at the time of harvesting. There were no significant differences in the endothelial loss between vsE and vsO groups at the time of harvesting and at the time before the implantation of the distal part. A higher number of endothelial cells was found in vsE group compared to vsO group at the time just before the implantation of the proximal part. The comparison of the implanted portions of vsE and vsO grafts to mammary arteries revealed a significant loss of endothelial cells only in vsO graft. We conclude that, at the time of implantation, the endothelial layer of the vein graft harvested endoscopically is more preserved than of the vein graft harvested openly.

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Activated Partial Thromboplastin Time and Mortality in Coronary Artery Bypass Grafting Patients

Zhang

Tian

et al. 2022

Disease Markers

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Background To evaluate the prognostic value of preoperative activated partial thromboplastin time (APTT) in patients who underwent coronary artery bypass grafting (CABG). Methods All data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. The study population was divided to two groups according to the optimal cut-off value of APTT calculated by X-tile software, and Cox proportional hazard model was used to define independent effect of APTT on 4-year mortality. Survival curves were estimated by the Kaplan-Meier method, and the area under the receiver-operating characteristic curve (AUC) was calculated to compare APTT with other severity scores. Propensity score matching (PSM) analysis were applied to ensure the robustness of this study. Results A total of 2,706 patients were included. The optimal cut-off value of APTT for 4-year mortality was 44 seconds. The Cox proportional hazard model showed that patients with APTT ≥ 44 had a significantly higher risk of all-cause death than those with APTT < 44 both before (HR (95% CI), 1.42 (1.16-1.74), P < 0.001) and after PSM (HR (95% CI), 1.47 (1.14-1.89), P = 0.003). The survival curves showed that patients with longer APTT had a significantly lower 1-year and 4-year cumulative survival probability. The ROC of APTT combined with other severity scores significantly increased predictive ability for 1-year and 4-year mortality. Conclusions A longer APTT (≥44) was associated with a higher risk of mortality and can serve as a prognostic predictor in CABG patients.

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Changes in activated partial thromboplastin time and international normalised ratio after on-pump and off-pump surgical revascularization of the heart

Cited by 4 publications

References 20 publications

Interaction between warfarin and short-term intravenous amiodarone in intensive care unit patients after cardiac surgery

Interaction between warfarin and short-term intravenous amiodarone in intensive care unit patients after cardiac surgery

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Activated Partial Thromboplastin Time and Mortality in Coronary Artery Bypass Grafting Patients

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