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Impact of preoperative fibrinogen concentration on postoperative outcome in patients who received dual antiplatelet therapy in proximity to off-pump coronary bypass surgery

Authors
 Na Young Kim  ;  Jae-Kwang Shim  ;  Jong Wook Song  ;  Eui-Kyung Kim  ;  Young-Lan Kwak 
Citation
 Circulation Journal, Vol.78(7) : 1661-1666, 2014 
Journal Title
 Circulation Journal 
ISSN
 1346-9843 
Issue Date
2014
Abstract
Background: Preoperative fibrinogen concentration is associated with increased blood loss at the lower end, and with hypercoagulability-related ischemic event at the higher end in cardiac patients. We evaluated the influence of preoperative fibrinogen concentration on blood loss and outcome in patients who received clopidogrel in proximity to off-pump coronary artery bypass surgery (OPCAB). Methods and Results: Medical records of 538 patients who received clopidogrel within 5 days of OPCAB (April 2007 to March 2012) were retrospectively reviewed. Perioperative bleeding and composite of morbidity endpoints including myocardial infarction were compared in relation to the tertile distribution of the fibrinogen concentration. The amount of blood loss was significantly larger in the first tertile, whereas the incidence of composite of morbidity endpoints was significantly higher in the third tertile. In multivariate analysis for risk factors of perioperative blood loss, body mass index and duration of surgery were identified as independent risk factors but not the fibrinogen level. And hypertension and preoperative fibrinogen level were identified as independent risk factors about composite of morbidity. The third tertile was associated with a 2-fold increased risk of developing composite of morbidity endpoints. Conclusions: In patients who received dual antiplatelet therapy in proximity to OPCAB, increased preoperative fibrinogen concentration could serve as a valuable predictor for composite of morbidity endpoints, whereas low fibrinogen concentration was not found to be a risk factor of bleeding.
Files in This Item:
T201401827.pdf Download
DOI
10.1253/circj.CJ-14-0161
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
곽영란(Kwak, Young Lan) ORCID logo https://orcid.org/0000-0002-2984-9927
김나영(Kim, Na Young) ORCID logo https://orcid.org/0000-0003-3685-2005
송종욱(Song, Jong Wook) ORCID logo https://orcid.org/0000-0001-7518-2070
심재광(Shim, Jae Kwang) ORCID logo https://orcid.org/0000-0001-9093-9692
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98954
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