Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery

Kim, Na Young; Shim, Jæ Kwang; Bang, Seo Ouk; Sim, Jee Suk; Song, Jong Wook; Kwak, Young Lan

doi:10.4097/kjae.2013.64.2.105

Cited by 10 publications

(5 citation statements)

References 28 publications

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“…Off-pump coronary artery bypass (OPCAB) surgery is a technique that involves grafting veins or arteries to bypass the narrowed or blocked areas, thus improving blood flow and reducing the risk of death from coronary artery disease (80). However, individuals who undergo this procedure may experience complications related to coagulation and hemostasis (81). Thus, there is a need to investigate the molecular mechanisms underlying the impact of OPCAB.…”

Section: Roles Of Mir-367 In Disease Pathogenesismentioning

confidence: 99%

Dysregulated expression of miR‑367 in disease development and its prospects as a therapeutic target and diagnostic biomarker (Review)

Muniandy,

Few,

Khoo

et al. 2023

Biomed Rep

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MicroRNA (miR)-367 has a wide range of functions in gene regulation and as such plays a critical role in cell proliferation, differentiation and development, making it an essential molecule in various physiological processes. miR-367 belongs to the miR-302/367 cluster and is located in the intronic region of human chromosome 4 on the 4q25 locus. Dysregulation of miR-367 is associated with various disease conditions, including cancer, inflammation and cardiac conditions. Moreover, miR-367 has shown promise both as a tumor suppressor and a potential diagnostic biomarker for breast, gastric and prostate cancer. The elucidation of the essential role of miR-367 in inflammation, development and cardiac diseases emphasizes its versatility in regulating various physiological processes beyond cancer biology. However, further research is necessary to fully understand the complex regulatory mechanisms involving miR-367 in different physiological and pathological contexts. In conclusion, the versatility and significance of miR-367 makes it a promising candidate for further study and in the development of new diagnostic and therapeutic strategies. Contents 1. Introduction 2. miRNA biogenesis 3. Roles of miR-367 in disease pathogenesis 4. Conclusion and future perspectives

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Section: Roles Of Mir-367 In Disease Pathogenesismentioning

confidence: 99%

Dysregulated expression of miR‑367 in disease development and its prospects as a therapeutic target and diagnostic biomarker (Review)

Muniandy,

Few,

Khoo

et al. 2023

Biomed Rep

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show abstract

“…With the unavoidable interference in the coagulation cascade, however, DAPT is accompanied by an inevitable increase in bleeding risk, even in patients not exposed to surgical procedures [ 5 ]. In this context, surgery not only exposes the patients to additional bleeding risk but also exposes them to an increased risk of thrombosis due to the development of hypercoagulability during the early postoperative period as a result of systemic inflammation [ 6 7 ]. Unfortunately, approximately 5–20% of patients undergoing PCI are presented for non-cardiac surgery within the first 2 years after PCI [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Dual antiplatelet therapy and non-cardiac surgery: evolving issues and anesthetic implications

Song

Soh

Shim

2017

Korean J Anesthesiol

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Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES). The mandatory interval of 1 year for elective surgery after DES implantation was shortened to 6 months (3 months if surgery cannot be further delayed). After this period, it is generally recommended that the P2Y12 inhibitor be stopped for the amount of time necessary for platelet function recovery (clopidogrel 5–7 days, prasugrel 7–10 days, ticagrelor 3–5 days), and that aspirin be continued during the perioperative period. In emergent or urgent surgeries that cannot be delayed beyond the recommended period after PCI, proceeding to surgery with continued DAPT should be considered. For intracranial procedures or other selected surgeries in which increased bleeding risk may also be fatal, cessation of DAPT (possibly with continuation or minimized interruption [3–4 days] of aspirin) with bridge therapy using short-acting, reversible intravenous antiplatelet agents such as cangrelor (P2Y12 inhibitor) or glycoprotein IIb/IIIa inhibitors (tirofiban, eptifibatide) may be contemplated. Such a critical decision should be individually tailored based on consensus among the anesthesiologist, cardiologist, surgeon, and patient to minimize both ischemic and bleeding risks.

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“…Off-pump coronary artery bypass (OPCAB) surgery, in which veins or arteries are grafted to the coronary arteries to bypass atherosclerotic narrowing and improve the blood supply to the heart muscle, reduces the risk of mortality from coronary artery disease ( 2 ). However, coronary patients who have undergone OPCAB grafting often suffer from disorders of coagulation and hemostasis ( 3 ). Therefore, it is necessary to research the molecular mechanisms underlying the effect of OPCAB.…”

Section: Introductionmentioning

confidence: 99%

Expression profile analysis based on DNA microarray for patients undergoing off-pump coronary artery bypass surgery

Sun

Gao

Sun

et al. 2016

Experimental and Therapeutic Medicine

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Off-pump coronary artery bypass (OPCAB) surgery is the most effective treatment for coronary heart disease. The aim of this study was to explore the effects of OPCAB on the basis of the associated molecular mechanisms. GSE12486 expression profiles downloaded from the Gene Expression Omnibus database (GEO) were analyzed to identify the differentially expressed genes (DEGs). Principal component analysis (PCA) was conducted based on the expression profiles of DEGs. Function and pathway enrichment of upregulated DEGs was performed, followed by protein-protein interaction (PPI) network construction. Gene Set Enrichment Analysis (GSEA) was used for miRNA enrichment analysis based on expression profiles and prediction of their association with the disease. Cytoscape was applied to construct miRNA regulatory networks of DEGs. In total 64 DEGs were identified, including 63 upregulated and 1 downregulated gene. The first principal component in the PCA analysis was able to distinguish between pre- and post-OPCAB samples. Upregulated DEGs mainly enriched 20 Gene Ontology terms, such as chemokine activity, and 5 pathways including the chemokine signaling pathway. The constructed PPI network contained 234 edges and 55 nodes, and 10 upregulated hub nodes, including FBJ murine osteosarcoma viral oncogene homolog (FOS), were screened. A total of 36 miRNAs, including MIR-224 and MIR-7, were screened by GSEA enrichment analysis. A miRNA regulatory network including 176 edges and 97 nodes was constructed, showing the regulatory relationships between miRNAs and DEGs. For example, early growth response 2 (EGR2) was regulated by 8 miRNAs including MIR-150, MIR-142-3P, MIR-367 and MIR-224. The identified DEGs might play important roles in patients pre- and post-OPCAB surgery via the regulation of associated genes.

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Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery

Cited by 10 publications

References 28 publications

Dysregulated expression of miR‑367 in disease development and its prospects as a therapeutic target and diagnostic biomarker (Review)

Dysregulated expression of miR‑367 in disease development and its prospects as a therapeutic target and diagnostic biomarker (Review)

Dual antiplatelet therapy and non-cardiac surgery: evolving issues and anesthetic implications

Expression profile analysis based on DNA microarray for patients undergoing off-pump coronary artery bypass surgery

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