To understand the coagulation changes after off-pump coronary artery bypass (OPCAB) surgery, we evaluated the procoagulant activity of microparticles (MPs) and microparticles exposing tissue factor (MPs-TF), together with the levels of total tissue factor (TF), protein Z (PZ), protein Z-dependent protease inhibitor (ZPI), and factor X (FX) before (first day) and 1 week after surgery (seventh day) in plasma samples from 30 patients. Twenty healthy controls were also included. Compared to the controls, patients scheduled for surgery had significantly higher MPs-TF procoagulant activity and lower TF levels ( P = .0006, P = .02, respectively). In the whole cohort, median procoagulant activity of MPs-TF and median levels of TF and ZPI were significantly lower ( P = .02, P = .0003, and P = .004, respectively), while median levels of PZ and FX were significantly higher ( P = .02 and P = .002, respectively) on the seventh day compared to the first day. Our results suggest that OPCAB surgery has a significant effect on the procoagulant activity of MPs-TF and the PZ system.
Background: Considerable attention has been focused over the past several years on the protein Z (PZ) system. However, little is known
about the role of auto-antibodies to PZ (anti-PZ) in cardiac surgery patients.<br>Aim: In the present pilot study, we investigated plasma levels of anti-PZ in patients undergoing off-pump coronary artery bypass
(OPCAB) surgery.<br>Material and methods: Thirty patients with coronary artery disease scheduled for OPCAB surgery were enrolled in this study. Plasma levels
of anti-PZ IgM and anti-PZ IgG were measured before surgery and one week after surgery using enzyme-linked immunosorbent assay.<br>Results: None of the subjects were shown to have positive results for anti-PZ IgM and anti-PZ IgG either before and one week after
OPCAB surgery.<br>Conclusions: These results suggest that anti-PZ autoantibodies are not an effective component of the PZ system in OPCAB patients.
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