Effects of coronary artery by-pass grafting on haemostatic factors

BACKGROUND: Atherogenesis is triggered by functional or structural endothelial injury which leads to humoral and secretion alterations. The haemostatic system plays a significant role in the development of atherosclerosis and its complications, especially acute coronary syndromes. AIM: To assess the effects of coronary artery by-pass grafting (CABG) on some haemostatic factors in patients with stable coronary artery disease (CAD). METHODS: The study group consisted of 45 patients (11 females, 34 males, mean age 60.4+/-9.4 years, range 35-75 years). Endothelial function marker - von Willebrand factor (vWF), and thrombin generation parameters - thrombin-antithrombin complexes (TAT) and prothrombin fragments - F1+2 were measured before as well as 3 days, 7 days and 3 months after CABG. The control group consisted of 33 healthy volunteers (17 females, 16 males, mean age 48.8+/-17.2 years). RESULTS: Serum concentration of vWF as well as TAT and F1+2 levels were significantly higher in the CABG group than in controls. Compared with baseline values, the vWF levels were significantly higher 3 and 7 days after CABG. CONCLUSIONS: There is a hypercoagulability state in patients with CAD who undergo CABG. The use of extracorporeal circulation causes a significant increase in the vWF level which suggests a marked endothelial injury caused by CABG procedure.