Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

Salehiomran, Abbas; Ahmadi, Hossein; Karimi, Abbasali; Tazik, Mokhtar; Dowlatshahi, Samaneh; Fathollahi, Mahmood Sheikh; Abbasi, Seyed Hesameddin

doi:10.2478/s11536-009-0044-3

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Coronary artery bypass grafting (CABG) surgery is an effective treatment for patients with 3-vessel coronary artery disease (CAD). Dual antiplatelet therapy (DAPT) prior to CABG may increase the risks of postoperative hemorrhage and blood product transfusion, leading to enhanced in-hospital mortality and morbidity rates (1,2).…”

Section: Introductionmentioning

confidence: 99%

MiR-223 levels predicting perioperative bleeding in off-pump coronary artery bypass grafting

Wang¹,

Xia²,

Xu³

et al. 2020

Ann Transl Med

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Background: To investigate the predictive value of platelet-related microRNAs (miRNAs) for bleeding during and after off-pump coronary artery bypass grafting (OPCABG) and the influence of dual antiplatelet therapy (DAPT) on miRNAs.Methods: This prospective study included 59 patients scheduled for OPCABG. The plasma miR-126 and miR-223 levels were measured and platelet aggregation was determined by thromboelastography during DAPT. The plasma miRNA levels were compared between patients treated with ticagrelor or clopidogrel. Multivariable logistic regression analysis was performed to determine the independent risk factors for bleeding during and after surgery. Active bleeding was defined as a blood loss >1.5 mL/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation during the first 12 postoperative hours. Severe perioperative bleeding was defined using the universal definition of perioperative bleeding in adult cardiac surgery. Results: Higher circulating miR-223 levels [odds ratio (OR) =1.348, 95% confidence interval (CI): 1.001-1.814, P=0.047] and lower body mass index (OR =0.648, 95% CI: 0.428-0.980, P=0.040) were independent predictors for severe perioperative bleeding in OPCABG. Ticagrelor treatment led to significant increases in circulating miR-223 levels compared with clopidogrel treatment. Conclusions: The plasma miR-223 levels served as a predictor for bleeding during and after OPCABG. Circulating miR-223 levels were significantly elevated with ticagrelor treatment compared with clopidogrel treatment. MiR-223 may be a novel biomarker for bleeding in cardiac surgery and can help explain the different efficacies of ticagrelor and clopidogrel.

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Section: Introductionmentioning

confidence: 99%

MiR-223 levels predicting perioperative bleeding in off-pump coronary artery bypass grafting

Wang¹,

Xia²,

Xu³

et al. 2020

Ann Transl Med

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“…It is also well known that in vitro activation of thrombocytes induce morphologic, functional, and ultrastructural changes. These changes could reduce the viability of thrombcytes, as well as their in vivo functionality and clinical efficacy [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

The effect of a leukodepletion model on the activation stage of platelets

et al. 2011

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AbstractThe preparation of thrombocyte concentrates with filtration before storage (in-line) makes it possible to avoid the presence of mononuclear cells in the concentrate and proinflammatory cytokines. Therefore, this filtration may result with decreased activation of trombocyte receptors in vitro, which may improve therapeutic efficiancy. Methods. We compared two groups, each with 30 therapeutic doses of concentrated thrombocytes. We prepared the first group using the classic model from the buffy coat and the other with concentrated thrombocyte samples filtrated during sampling, so-called in-line, with the WBC filter Imuflex (Terumo). Mononuclear cells (MNC), thrombocyte, and erythrocyte counts in the units of concentrated thrombocytes were obtained on an automatic cell counter, and we used flow cytometry to measure the expression of surface thrombocyte receptors. The results demonstrated that the trombocytes prepared with pre-storage filtration contained a very low level of mononuclear cells and markedly reduced trombocyte receptors. Conclusion. The number of MNC and expression of surface thrombocyte receptors were markedly lower in the concentrated thrombocyte units prepared with in-line filtration. The thrombocytes prepared in this way contain fewer mononuclear cells, are of higher quality, are more functional, and may produce a better therapeutic effect in vivo.

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A systematic review of the effect of red blood cell transfusion on mortality: evidence from large-scale observational studies published between 2006 and 2010

et al. 2013

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ObjectiveTo carry out a systematic review of recently published large-scale observational studies assessing the effects of red blood cell transfusion (RBCT) on mortality, with particular emphasis on the statistical methods used to adjust for confounding. Given the limited number of randomised trials of the efficacy of RBCT, clinicians often use evidence from observational studies. However, confounding factors, for example, individuals receiving blood generally being sicker than those who do not, make their interpretation challenging.DesignSystematic review.Information sourcesWe searched MEDLINE and EMBASE for studies published from 1 January 2006 to 31 December 2010.Eligibility criteria for included studiesWe included prospective cohort, case–control studies or retrospective analyses of databases or disease registers where the effect of risk factors for mortality or survival was examined. Studies must have included more than 1000 participants receiving RBCT for any cause. We assessed the effects of RBCT versus no RBCT and different volumes and age of RBCT.Results–32 studies were included in the review; 23 assessed the effects of RBCT versus no RBCT; 5 assessed different volumes and 4 older versus newer RBCT. There was a considerable variability in the patient populations, study designs and level of statistical adjustment. Overall, most studies showed a higher rate of mortality when comparing patients who received RBCT with those who did not, even when these rates were adjusted for confounding; the majority of these increases were statistically significant. The same pattern was observed in studies where protection from bias was likely to be greater, such as prospective studies.ConclusionsRecent observational studies do show a consistently adverse effect of RBCT on mortality. Whether this is a true effect remains uncertain as it is possible that even the best conducted adjustments cannot completely eliminate the impact of confounding.

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Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

Cited by 4 publications

References 25 publications

MiR-223 levels predicting perioperative bleeding in off-pump coronary artery bypass grafting

MiR-223 levels predicting perioperative bleeding in off-pump coronary artery bypass grafting

The effect of a leukodepletion model on the activation stage of platelets

A systematic review of the effect of red blood cell transfusion on mortality: evidence from large-scale observational studies published between 2006 and 2010

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