Early effect of different antithrombotic therapy after coronary endarterectomy combined with coronary artery bypass graft
10.3760/cma.j.cn112434-20220203-00038
- VernacularTitle:冠状动脉内膜剥脱术联合冠状动脉旁路移植术后不同抗凝方案的早期效果观察
- Author:
Haitao LI
1
;
Chengxiong GU
;
Haiyang LI
;
Hui LI
;
Jingxing LI
Author Information
1. 首都医科大学附属北京安贞医院心脏外科，北京 100029
- Keywords:
Coronary artery bypass grafting;
Coronary endarterectomy;
Antithrombotic therapy;
Early effect
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(5):292-295
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the early effect of different antithrombotic therapy in patients with coronary endarterectomy(CE) combined with off-pump coronary artery bypass grafting(OPCABG).Methods:Between January and December 2021, 154 consecutive patients including 120 males and 34 females with the age ranged from 39 to 78 years and an average of(62.6±7.2) years who underwent CE+ OPCABG were evaluated retrospectively. According to the postoperative anticoagulant therapy, patients were divided into two groups: Aspirin+ low molecular weight heparin group(n=81, LMWH group) and Aspirin+ ticagrelor group(n=73, ticagrelor group). The data of both preoperative and postoperative hemoglobin level and blood transfusion after the surgery were collected. The dynamic changes of electrocardiogram and cTnI level were observed within 48 h after the surgery.Results:There was no perioperative death, and all the patients were discharged 5-13 days postoperatively. After the initiation of anticoagulant therapy, the lowest hemoglobin value in the LMWH group and ticagrelor group was(88.3±14.6)g/L vs.(89.5±11.6)g/L( P>0.05), blood transfusion was performed in 8 vs. 5 patients with hemoglobin below 70g/L( P>0.05), peak cTnI within 48 h of surgery was 850.55(410.63, 1 662.63)pg/ml vs. 1 184.60(667.50, 3 169.63)pg/ml( P<0.05), the number of patients with perioperative myocardial infraction within 48h after the surgery confirmed by electrocardiogram was 2(2.5%) vs.2(2.5%), P>0.05. Conclusion:There was no significant difference between the two anticoagulant treatments in preventing perioperative myocardial infarction after CE+ OPCABG surgery. LMWH did not increase the risk of postoperative bleeding compared with ticagrelor. In addition, aspirin+ LMWH reduced the levels of peak TnI within 48 h of surgery, which may be associated with better long-term postoperative outcomes, but further research is needed to confirm this.
