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Antithrombin activity and outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass

AuthorsMuedra, Vicente; Barettino, Domingo ; D’Ocón, Pilar; Zuñiga, Angel; Moreno, Lucrecia
Cardiopulmonary bypass
Extracorporeal circulation
Issue Date1-Jun-2013
PublisherLippincott Williams & Wilkins
CitationBlood Coagulation and Fibrinolysis 24(4):454-7 (2013)
AbstractBackground: We recently reported prospective results from a cohort of patients scheduled for elective cardiac surgery with cardiopulmonary bypass (CPB) in which most baseline clinical parameters of patients and surgery outcomes failed to demonstrate relationships with post-CPB antithrombin (AT) activity. Objective and Methods: In this extension study, a larger sample size (250 patients) was analyzed following general linear models. Patients’ demographic and pre-CPB clinical data as well as pre/post-CPB AT activity and outcomes were collected. Results: There was a significant decrease of post-CPB AT activity (95.6±13.7% to 64.6±12.1%; p<0.001). Univariate and multivariate analyses revealed that a decrease of ~1% post-CPB AT activity may be expected per 3 years increase in patient’s age. Univariate analysis showed that post-CBP AT activity was inversely related to the need for transfusions,acute renal failure and occurrence of any complication (re-intervention, low cardiac output,arrhythmia, lung dysfunction, stroke, acute renal failure, mesenteric ischemia and re-hospitalization; P<0.05). Multivariate analysis adjusted for age and pre-CPB AT did not show statistical significance. Odds ratio (OR) <1 was observed in most outcomes (0.8 in average), which suggested a reduction of the probability for an increase of 10% in post-CBP AT. Conclusions: Our results confirm the role of low postsurgery AT activity influencing outcomes in patients undergoing CPB.
Description14 páginas, 1 figura, 1 tabla
Publisher version (URL)http://dx.doi.org/10.1097/MBC.0b013e32835d5422
Appears in Collections:(IBV) Artículos
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