Coagulation Activation and Organ Dysfunction Following Cardiac Surgery

Dixon, Barry; Santamaria, John; Campbell, Duncan J.

doi:10.1378/chest.128.1.229

Cited by 58 publications

(31 citation statements)

References 54 publications

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“…Previous studies measuring PAI-1 concentrations after cardiac surgery have produced inconsistent results (17)(18)(19). Valen et al (19) found that CPB was associated with an increase in tPA and a decrease in PAI-1 levels.…”

Section: Discussionmentioning

confidence: 99%

Coagulopathy After Cardiac Surgery May Be Influenced by a Functional Plasminogen Activator Inhibitor Polymorphism

Duggan

O'Dwyer²,

Caraher³

et al. 2007

Anesthesia &Amp; Analgesia

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BACKGROUND: Cytokine-mediated inflammation and coagulopathy may occur after cardiac surgery. In this study we investigated the temporal pattern of plasminogen activator inhibitor-1 (PAI-1) gene expression after cardiac surgery and its relation with PAI genotype, and obtained preliminary data regarding its relation to perioperative morbidity. METHODS: The relative change in PAI-1 mRNA 1, 6, and 24 h after cardiopulmonary bypass (CPB) was measured from mononuclear cells in 82 patients undergoing elective cardiac surgery. DNA was analyzed for carriage of the 4G/5G PAI-1 polymorphism. RESULTS: PAI-1 gene expression decreased after CPB in all patients. A larger reduction in PAI-1 gene expression was observed in homozygous carriers of the 5G allele. Homozygous carriers of the 5G allele were also more likely to receive transfusion of coagulation blood products. There was no relation between change in PAI-1 gene expression and duration of CPB. CONCLUSIONS: PAI-1 gene expression decreased over time after CPB. We found a link between PAI-1 genotype, PAI gene expression, and transfusion of coagulation products after cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Coagulopathy After Cardiac Surgery May Be Influenced by a Functional Plasminogen Activator Inhibitor Polymorphism

Duggan

O'Dwyer²,

Caraher³

et al. 2007

Anesthesia &Amp; Analgesia

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“…This may cause a consumptive coagulopathy, which is responsible for thromboembolic events and non-surgical haemorrhage after CPB [14]. Thus, increased levels of biomarkers of activated coagulation pathways are associated with negative outcomes after cardiac surgery [15].…”

Section: Coagulation Linked To Inflammationmentioning

confidence: 99%

Inflammatory response and extracorporeal circulation

Kraft

Schmidt

Aken

et al. 2015

Best Practice & Research Clinical Anaesthesiology

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“…25,31 The risk of perioperative stroke depends on patient characteristics 26,29,32 ; the nature and timing of the procedure 25,26,[32][33][34][35] ; and certain complications in the postoperative period, including postoperative atrial fibrillation 36,37 and hypercoagulability. 35,38,39 This section will focus on the assessment and modification of patient-related (ie, preoperative) risk factors. By and large, preoperative risk factors are a reflection of the traditional risk factors for stroke in the general population.…”

Section: Cerebrovascular and Carotid Diseasementioning

confidence: 99%

The Preoperative Neurological Evaluation

Probasco

Sahin

Tran

et al. 2013

The Neurohospitalist

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Neurological diseases are prevalent in the general population, and the neurohospitalist has an important role to play in the preoperative planning for patients with and at risk for developing neurological disease. The neurohospitalist can provide patients and their families as well as anesthesiologists, surgeons, hospitalists, and other providers guidance in particular to the patient's neurological disease and those he or she is at risk for. Here we present considerations and guidance for the neurohospitalist providing preoperative consultation for the neurological patient with or at risk of disturbances of consciousness, cerebrovascular and carotid disease, epilepsy, neuromuscular disease, and Parkinson disease.

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Coagulation Activation and Organ Dysfunction Following Cardiac Surgery

Cited by 58 publications

References 54 publications

Coagulopathy After Cardiac Surgery May Be Influenced by a Functional Plasminogen Activator Inhibitor Polymorphism

Coagulopathy After Cardiac Surgery May Be Influenced by a Functional Plasminogen Activator Inhibitor Polymorphism

Inflammatory response and extracorporeal circulation

The Preoperative Neurological Evaluation

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