Long Period and High Level of D-Dimer after Coronary Artery Bypass Grafting Surgery

Abstract

SummaryHyper-coagulation after off-pump coronary artery bypass grafting (OPCAB) is one of the main reasons for graft thrombosis. D-dimer is closely linked to the activation of coagulation. Few studies have reported the variation range and long-term abnormal coagulation after OPCAB in the Chinese population. Our study aimed to determine the characteristics and value of D-dimer after OPCAB.In this prospective study, 265 patients who underwent OPCAB for the first time were recruited from 2011 to 2012. The D-dimer level of the patients was tested before surgery and on the 1st, 4th, and 14th day, and 1st, 2nd, and 3rd month after surgery. Clinical data in the perioperative period and during the one-year follow-up period were recorded.D-dimer level increased from day 4 after OPCAB ([1321.9 ± 36.4] μg/L), peaked at 1 month ([2839.7 ± 101.4] μg/L), and decreased to the baseline ([370.3 ± 260.2] μg/L) 3 months after surgery. No death occurred, but 25 (10%) patients suffered recurrent angina in the one-year follow-up. They had significantly higher Ddimer level at one month after OPCAB than those of patients who did not suffer from angina. Preoperative ejection fraction <50% and D-dimer level >2915 μg/L at one month after surgery were significantly associated the recurrent angina.After OPCAB, patients have a higher level of D-dimer. And this lasts for a long period (about 3 months). It may reflect a certain degree of hypercoagulable and hyperfibrinolytic state after OPCAB.(Int Heart J 2018; 59: 51-57)

The Role of Serum Tenascin-C in Predicting In-Hospital Death in Acute Aortic Dissection

“…18) Additionally, in human abdominal aortic aneurysm specimens, a strong and patch TNC staining was observed in the most dilated region of the aneurysm accompanied by severe tissue destruction. 19,20) Subsequently, elevated TNC expres-sion in aortic tissue released into blood, resulting in the elevated serum TNC levels. In addition, multiple logistic regression analysis revealed that serum TNC was an independent factor in predicting in-hospital death from acute AD.…”

“…DD is a small protein fragment that is the product of fibrin degradation after a blood clot degraded by fibrinolysis. 20) Previous studies demonstrated that DD was a good rule-out tool for acute AD, and acute AD would be excluded when DD levels were below 0.1 μg/mL with a sensitivity of 100%. 21) Recently, increased DD levels were observed in patients with type A acute AD, those who died during hospitalization, or those with severe complications.…”

D-Dimer to Predict the Clinical Outcomes in Patients with Mechanical Heart Valve Replacement During Oral Anticoagulation Therapy

“…D-dimer elevation may be seen in several diseases or situations. 6,7,21) Historically, a lack of specificity has been regarded as a disadvantage of D-dimer assessments; however, the low specificity has been transformed into an advantage in the evaluation of anticoagulation prognosis. In the current study, 3 patients died from heart failure, 1 patient died from cancer, and most of them (3/4) had abnormal D-dimer levels.…”

“…D-dimer, a product of cross-linked fibrin degradation, is only produced when both the blood coagulation and fibrinolytic pathways are concomitantly activated. 4,5) Elevated D-dimer levels are highly correlated with adverse clinical outcomes, including thrombotic or cardiovascular events and other severe conditions, [5][6][7] which cover most complications during oral anticoagulation therapy. 8) Previous studies reported that D-dimer exhibited a good prognostic value in patients with atrial fibrillation (AF) or cancer.…”

Hemostasis parameters in patients after coronary artery bypass surgery for stable angina

“…Согласно имеющимся литературным данным, активация системы гемостаза после операции КШ влияет на вероятность неблагоприятных клинических исходов. В частности, более высокие уровни D-димера через месяц после КШ ассоциированы с рецидивом стенокардии [5]. B. Yanagawa и соавт.…”