Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

01 February 2012

The influence of heparin resistance on postoperative complications in patients undergoing coronary surgery

Piotr KnapikACDEFG, Daniel CieślaABCDE, Roman PrzybylskiADEFG, Tomasz KnapikABDEF

DOI: 10.12659/MSM.882465

Med Sci Monit 2012; 18(2): CR105-111

Abstract

Background: Heparin resistance is relatively frequent in patients undergoing coronary surgery. We aimed to assess the impact of heparin resistance on the outcome of patients undergoing coronary surgery with cardiopulmonary bypass (CABG). Three definitions of heparin resistance were adopted.
Material/Methods: We performed a retrospective review of 756 consecutive patients undergoing isolated CABG. All anaesthesia records were reviewed manually. Heparin resistance was recognized if: ACT was less than 400 seconds after 300 U/kg heparin (local criteria), ACT was less than 480 seconds after 400 U/kg or more heparin (stringent criteria), or if heparin sensitivity index was lower than 1.3. Postoperative assessment included perioperative morbidity and mortality. A multiple logistic regression model was used to investigate the influence of all demographic, preoperative and surgical variables, as well as heparin resistance (variably defined) on hospital mortality and postoperative complications.
Results: Heparin sensitivity index, local criteria and stringent criteria identified 64.8%, 12.0% and 4.3% heparin resistant patients, respectively. Heparin-resistant patients more frequently had preoperative heparin administration, unstable course of coronary artery disease, and higher coronary symptoms scoring. Severe form of heparin resistance (expressed by the ACT less than 480 seconds after 400 U/kg heparin) was an independent predictor of death (OR 4.92; CI 1.11–21.89).
Conclusions: Mild forms of heparin resistance are relatively frequent and are not associated with increased morbidity and mortality. The isolation of severe heparin resistance as an independent predictor of death in our large cohort of coronary patients suggests that this phenomenon should be given more attention in future studies.

Keywords: Hospital Mortality, Heparin - therapeutic use, Coronary Artery Disease - surgery, Coronary Artery Bypass - mortality, Postoperative Complications - etiology

Add Comment 0 Comments

Editorial

01 February 2025 : Editorial  

Editorial: Current Approaches to Screening for Lung Cancer in Smokers and Non-Smokers

Dinah V. Parums

DOI: 10.12659/MSM.948255

Med Sci Monit 2025; 31:e948255

0:00

In Press

Clinical Research  

Predicting Cerebral Small Vessel Disease Burden Based on Thromboelastography in Patients with Acute Ischemi...

Med Sci Monit In Press; DOI: 10.12659/MSM.946303  

Clinical Research  

Long-Term Outcomes of Implanon in Managing Adenomyosis: A 3-Year Prospective Study

Med Sci Monit In Press; DOI: 10.12659/MSM.945972  

Laboratory Research  

Linear Dimensional Accuracy in Maxillomandibular Records: A Comparative Study of Scannable and Transparent ...

Med Sci Monit In Press; DOI: 10.12659/MSM.947265  

Clinical Research  

Efficacy of King's Combined Uterine Suture in Managing Placenta Accreta: A Retrospective Analysis

Med Sci Monit In Press; DOI: 10.12659/MSM.945826  

Most Viewed Current Articles

17 Jan 2024 : Review article   6,969,932

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

16 May 2023 : Clinical Research   701,896

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

01 Mar 2024 : Editorial   25,741

Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and ...

DOI :10.12659/MSM.944204

Med Sci Monit 2024; 30:e944204

0:00

28 Jan 2024 : Review article   20,253

A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and Future

DOI :10.12659/MSM.943912

Med Sci Monit 2024; 30:e943912

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750