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Anesth Analg 2007;104:1343-1347
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000261267.28891.00

CARDIOVASCULAR ANESTHESIA

Coagulopathy After Cardiac Surgery May Be Influenced by a Functional Plasminogen Activator Inhibitor Polymorphism

Edel Duggan, MB, FFARCSI*, Michael J. O’Dwyer, MB, FFARCSI*, Emma Caraher, PhD{dagger}{ddagger}, Dara Diviney, MB, FFARCSI*, Eilis McGovern, MB, FRCSI§, Dermot Kelleher, MD, FRCPI{dagger}{ddagger}, Ross McManus, PhD{dagger}{ddagger}, and Thomas Ryan, MB, FFARCSI*

From the *Department of Anaesthesia; {dagger}Department of Clinical Medicine; {ddagger}Dublin Molecular Medicine Centre, Trinity Centre for Health Sciences; and §Department of Cardiothoracic Surgery, St. James’s Hospital, Dublin, Ireland.

BACKGROUND: Cytokine-mediated inflammation and coagulopathy may occur after cardiac surgery. In this study we investigated the temporal pattern of plasminogen activator inhibitor-1 (PAI-1) gene expression after cardiac surgery and its relation with PAI genotype, and obtained preliminary data regarding its relation to perioperative morbidity.

METHODS: The relative change in PAI-1 mRNA 1, 6, and 24 h after cardiopulmonary bypass (CPB) was measured from mononuclear cells in 82 patients undergoing elective cardiac surgery. DNA was analyzed for carriage of the 4G/5G PAI-1 polymorphism.

RESULTS: PAI-1 gene expression decreased after CPB in all patients. A larger reduction in PAI-1 gene expression was observed in homozygous carriers of the 5G allele. Homozygous carriers of the 5G allele were also more likely to receive transfusion of coagulation blood products. There was no relation between change in PAI-1 gene expression and duration of CPB.

CONCLUSIONS: PAI-1 gene expression decreased over time after CPB. We found a link between PAI-1 genotype, PAI gene expression, and transfusion of coagulation products after cardiac surgery.




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 Anesth. Analg.Home page
J. J. Jimenez and J. L. Iribarren
Coagulopathy After Cardiac Surgery
Anesth. Analg., November 1, 2007; 105(5): 1514 - 1514.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.