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

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

Abstract

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, 5 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 5 days of aspirin and clopidogrel therapy following OPCABG.