Qualitative and quantitative changes in platelets after coronary-artery bypass surgery may help identify thrombotic complications and infections

Abstract

We studied the effect of coronary-artery bypass surgery on blood cells and platelets. Hematological parameters of eighty-three patients were measured by an automated cell counting and sizing analyzer. Sampling time was from 24 h prior to 10 days after surgery. During this time leukocytes and platelets showed characteristic changes in numbers and size, whereas red blood cells revealed no typical modifications. Even though it seems clear that changes of hematological parameters occur after bypass surgery, it is important to be aware of the actual extent of such changes. Therefore the data of 50 patients who had had no post-operative clinical complications were combined to generate diagrams of those parameters that had changed in a characteristic fashion. The diagrams showing average changes, and 99% confidence intervals in mean platelet volume and platelet count were able to identify seven (out of 7) cases with complications up to 48 h before clinical signs were apparent. Complications ranged from mild (3 cases with infections) to severe (4 cases with thrombosis, embolic thrombosis and/or reinfarction). Diagrams showing changes in leukocyte parameters were able to identify only two cases with infections. Even though the number of cases is yet small, the results suggest that surveillance of platelet parameters may be useful in postoperative care. Furthermore, this study was able to confirm the recent findings of Trowbridge and Martin that an abnormal increase in platelet volume distribution width and low platelet counts found in patients with coronary heart disease may serve as good indicators for the prethrombotic state and the risk of myocardial infarction.

Perioperative Monitoring of Primary and Secondary Hemostasis in Coronary Artery Bypass Grafting

“…Postoperatively increased mean platelet volume in patients after CPB support as reported by von Ruecker and associates indicate a role of that mechanism. 26 Highly active platelets mobilized postoperatively may contribute to the short CADP-CT in patients with postoperative myocardial ischemia. Golanski and colleagues had attributed late platelet hyperreactivity occurring 7 days after CABG to increased frequencies of platelet membrane glycoprotein polymorphisms, for example, GPIa (807 C/T ) and GPIIIa (Pl A1/A2 ).…”

Static platelet adhesion, flow cytometry and serum TXB2 levels for monitoring platelet inhibiting treatment with ASA and clopidogrel in coronary artery disease: a randomised cross-over study

“…Similarly, the sustained inflammatory response may explain the significant increase in platelet count during combination therapy. Platelet counts may initially decrease after surgical procedures followed by recovery and increased platelet count within the following period of time [ 41 , 42 ]. This would be represented by the dual therapy group in the present study.…”

Value of Platelet Activation Markers as Prothrombotic Risk Indicators

“…In 1983 three reports were published demonstrating a relationship between MPV and myocardial infarction [144][145][146]. This relation was proved in many further and also in very recent studies, and evidence was provided that high MPV is an independent risk factor of myocardial infarction and a predictor of poor outcome [147][148][149][150][151]. Increased PMV was also shown in patients with ischaemic stroke [143,152] and other conditions with increased thrombotic risk such as diabetes mellitus, obesity and others [143,[153][154][155][156].…”