Article Abstract

Impact of diabetes mellitus on coagulation function before and after off-pump coronary artery bypass grafting

Authors: Dawei Wang, Yu Liu, Ziying Chen, Fei Yang, Zhenming Zhang, Yulei Wei


Background: This study aims to explore the influence of off-pump coronary artery bypass grafting (OPCABG) on coagulation function and the effects of diabetes on coagulation function during OPCABG.
Methods: Patients who met the inclusion and exclusion criteria were divided into two groups: diabetes mellitus (DM) and non-diabetes mellitus (NDM) groups. Thromboelastography (TEG) was tested at the following time points: T0, five days after aspirin and clopidogrel therapy, and before OPCABG; T1, returning to care unit after OPCABG; T2, five days after aspirin and clopidogrel therapy, and after OPCABG.
Results: A total of 56 patients were involved. There were no deaths, or no early postoperative thrombotic events and abnormal bleeding after OPCABG. Intra-group comparison: Compared with T0, the R and K value decreased, while the α angle and MA value increased at T1 and T2, in both groups (P<0.05). A significantly statistical difference was found in the multiple comparison at T0, T1 and T2 (P<0.05). The results are as follows: The R value decreased at T1 and increased at T2, but the value remained less than that at T0. After the OPCABG, the K value gradually decreased, while the MA value and α angle gradually increased. Comparison between groups: T1: the R values were lower in the DM group, when compared to the NDM group (t=3.611, P=0.001). The differences in the MA, K and α angle were not statistically significant. T0 and T2: there were no statistically difference in the R, MA, K, α angle and LY30 between the two groups (P>0.05).
Conclusions: The coagulation function of patients was at a hypercoagulable state at the early stage after OPCABG. The coagulation function was affected by diabetes at the day of OPCABG. However, there was no statistical difference after five days of aspirin and clopidogrel therapy following OPCABG.

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