Impaired fibrin clot lysis is associated with increased mortality in patients after coronary artery bypass grafting: A long‐term follow‐up study
Background Mortality after coronary artery bypass grafting (CABG) is primarily thromboembolic by nature. We investigated whether impaired fibrinolysis observed in cardiovascular diseases is associated with long‐term mortality following CABG. Methods The study population comprised 292 consecutive pat...
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| Veröffentlicht in: | European journal of clinical investigation 2022-07, Vol.52 (7), p.e13775-n/a |
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| creator | Gołąb, Aleksandra Plicner, Dariusz Wypasek, Ewa Natorska, Joanna Kapelak, Bogusław Plens, Krzysztof Undas, Anetta |
| description | Background
Mortality after coronary artery bypass grafting (CABG) is primarily thromboembolic by nature. We investigated whether impaired fibrinolysis observed in cardiovascular diseases is associated with long‐term mortality following CABG.
Methods
The study population comprised 292 consecutive patients (aged 64.6 ± 8.1 years) who underwent scheduled CABG. We measured plasma clot lysis time (CLT) preoperatively as a measure of fibrinolysis capacity. Cardiovascular and all‐cause deaths were recorded during a median follow‐up of 13.8 years.
Result
CLT positively correlated with age (r = .56, p |
| doi_str_mv | 10.1111/eci.13775 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2641855879</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2641855879</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3535-465c2b425c6ccf76a8c4df87ba328eb01b68b358ddb71ffb39090785270a43ea3</originalsourceid><addsrcrecordid>eNp1kc2KFDEUhYMoTju68AUk4MZZ1Ex-KpW0u6GZ0YYBN7ouklTSZkhVyiRFUzsfwYVP6JN4tUcXgiEQTs7H4SYHoZeUXFJYV86GS8qlFI_QhvJONIx37DHaEELbhm0lO0PPSrknhCjK2VN0xgWnnFC1Qd_346xDdgP2weQwYRtTxXEtoWDYupRkg67gH0P9jMNks9MF5Jhy1THUFe7wrGtwUwXeV5exTTlNOq9YZ5ArNusMQfiQwQ7T4S2-xjFNhx9fv4E9Yp9iTEdQy4xLXYb1OXridSzuxcN5jj7d3nzcvW_uPrzb767vGgsPEE3bCctMy4TtrPWy08q2g1fSaM6UM4SaThku1DAYSb03fEu2RCrBJNEtd5qfozen3DmnL4srtR9DsS5GPbm0lJ51LVVCKLkF9PU_6H1a8gTTASWFaokgDKiLE2VzKiU73885jPATPSX9r6p6qKr_XRWwrx4SFzO64S_5pxsArk7AMUS3_j-pv9ntT5E_AfK-obA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2675840502</pqid></control><display><type>article</type><title>Impaired fibrin clot lysis is associated with increased mortality in patients after coronary artery bypass grafting: A long‐term follow‐up study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Gołąb, Aleksandra ; Plicner, Dariusz ; Wypasek, Ewa ; Natorska, Joanna ; Kapelak, Bogusław ; Plens, Krzysztof ; Undas, Anetta</creator><creatorcontrib>Gołąb, Aleksandra ; Plicner, Dariusz ; Wypasek, Ewa ; Natorska, Joanna ; Kapelak, Bogusław ; Plens, Krzysztof ; Undas, Anetta</creatorcontrib><description>Background
Mortality after coronary artery bypass grafting (CABG) is primarily thromboembolic by nature. We investigated whether impaired fibrinolysis observed in cardiovascular diseases is associated with long‐term mortality following CABG.
Methods
The study population comprised 292 consecutive patients (aged 64.6 ± 8.1 years) who underwent scheduled CABG. We measured plasma clot lysis time (CLT) preoperatively as a measure of fibrinolysis capacity. Cardiovascular and all‐cause deaths were recorded during a median follow‐up of 13.8 years.
Result
CLT positively correlated with age (r = .56, p < .001), fibrinogen (r = .25, p = .002) and EuroSCORE I (r = .32, p < .001). The cardiovascular and overall mortality rates were 3.0 and 4.9 per 100 patient‐years (32.4% vs 52.8%) respectively. In patients who died from cardiovascular and all causes, CLT was prolonged compared with survivors (both p < .050). Multivariable Cox regression analysis adjusted for potential confounders showed that long‐term cardiovascular and all‐cause deaths were associated with CLT (HR per 10 min 1.206; 95% CI 1.037–1.402, p = .015 and HR 1.164; 96% CI 1.032–1.309, p = .012), low‐density lipoprotein cholesterol (HR per 1 mmol/L 1.556; 95% CI 1.205–2.010, p < .001 and HR 1.388; 96% CI 1.125–1.703, p = .002), C‐reactive protein (HR per 10 mg/L 1.171; 95% CI 1.046–1.312, p = .006 and HR 1.127; 95% CI 1.005–1.237, p = .022) and EuroSCORE I (HR 1.173; 95% CI 1.016–1.355, p = .030 and HR 1.183; 95% CI 1.059–1.317, p = .003 respectively). Type 2 diabetes was solely associated with overall mortality (HR 1.594; 96% CI 1.088–2.334, p = .017).
Conclusions
In this study, we showed that reduced fibrin clot susceptibility to fibrinolysis is weekly associated with long‐term mortality in advanced CAD.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.13775</identifier><identifier>PMID: 35313018</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Cardiovascular diseases ; Cholesterol ; clot lysis time ; Coronary artery ; Coronary Artery Bypass ; coronary artery bypass grafting ; Coronary Artery Disease - surgery ; Coronary vessels ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 ; Fatalities ; Fibrin ; Fibrin - metabolism ; Fibrin Clot Lysis Time ; Fibrinogen ; Fibrinolysis ; Follow-Up Studies ; follow‐up ; Grafting ; Heart surgery ; Humans ; Lysis ; Mortality ; Population studies ; Regression analysis ; Thromboembolism ; Treatment Outcome</subject><ispartof>European journal of clinical investigation, 2022-07, Vol.52 (7), p.e13775-n/a</ispartof><rights>2022 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2022 Stichting European Society for Clinical Investigation Journal Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-465c2b425c6ccf76a8c4df87ba328eb01b68b358ddb71ffb39090785270a43ea3</citedby><cites>FETCH-LOGICAL-c3535-465c2b425c6ccf76a8c4df87ba328eb01b68b358ddb71ffb39090785270a43ea3</cites><orcidid>0000-0003-3716-1724 ; 0000-0003-4773-7512 ; 0000-0003-3176-8007 ; 0000-0002-3687-512X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Feci.13775$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Feci.13775$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35313018$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gołąb, Aleksandra</creatorcontrib><creatorcontrib>Plicner, Dariusz</creatorcontrib><creatorcontrib>Wypasek, Ewa</creatorcontrib><creatorcontrib>Natorska, Joanna</creatorcontrib><creatorcontrib>Kapelak, Bogusław</creatorcontrib><creatorcontrib>Plens, Krzysztof</creatorcontrib><creatorcontrib>Undas, Anetta</creatorcontrib><title>Impaired fibrin clot lysis is associated with increased mortality in patients after coronary artery bypass grafting: A long‐term follow‐up study</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background
Mortality after coronary artery bypass grafting (CABG) is primarily thromboembolic by nature. We investigated whether impaired fibrinolysis observed in cardiovascular diseases is associated with long‐term mortality following CABG.
Methods
The study population comprised 292 consecutive patients (aged 64.6 ± 8.1 years) who underwent scheduled CABG. We measured plasma clot lysis time (CLT) preoperatively as a measure of fibrinolysis capacity. Cardiovascular and all‐cause deaths were recorded during a median follow‐up of 13.8 years.
Result
CLT positively correlated with age (r = .56, p < .001), fibrinogen (r = .25, p = .002) and EuroSCORE I (r = .32, p < .001). The cardiovascular and overall mortality rates were 3.0 and 4.9 per 100 patient‐years (32.4% vs 52.8%) respectively. In patients who died from cardiovascular and all causes, CLT was prolonged compared with survivors (both p < .050). Multivariable Cox regression analysis adjusted for potential confounders showed that long‐term cardiovascular and all‐cause deaths were associated with CLT (HR per 10 min 1.206; 95% CI 1.037–1.402, p = .015 and HR 1.164; 96% CI 1.032–1.309, p = .012), low‐density lipoprotein cholesterol (HR per 1 mmol/L 1.556; 95% CI 1.205–2.010, p < .001 and HR 1.388; 96% CI 1.125–1.703, p = .002), C‐reactive protein (HR per 10 mg/L 1.171; 95% CI 1.046–1.312, p = .006 and HR 1.127; 95% CI 1.005–1.237, p = .022) and EuroSCORE I (HR 1.173; 95% CI 1.016–1.355, p = .030 and HR 1.183; 95% CI 1.059–1.317, p = .003 respectively). Type 2 diabetes was solely associated with overall mortality (HR 1.594; 96% CI 1.088–2.334, p = .017).
Conclusions
In this study, we showed that reduced fibrin clot susceptibility to fibrinolysis is weekly associated with long‐term mortality in advanced CAD.</description><subject>Cardiovascular diseases</subject><subject>Cholesterol</subject><subject>clot lysis time</subject><subject>Coronary artery</subject><subject>Coronary Artery Bypass</subject><subject>coronary artery bypass grafting</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary vessels</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Fatalities</subject><subject>Fibrin</subject><subject>Fibrin - metabolism</subject><subject>Fibrin Clot Lysis Time</subject><subject>Fibrinogen</subject><subject>Fibrinolysis</subject><subject>Follow-Up Studies</subject><subject>follow‐up</subject><subject>Grafting</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Lysis</subject><subject>Mortality</subject><subject>Population studies</subject><subject>Regression analysis</subject><subject>Thromboembolism</subject><subject>Treatment Outcome</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc2KFDEUhYMoTju68AUk4MZZ1Ex-KpW0u6GZ0YYBN7ouklTSZkhVyiRFUzsfwYVP6JN4tUcXgiEQTs7H4SYHoZeUXFJYV86GS8qlFI_QhvJONIx37DHaEELbhm0lO0PPSrknhCjK2VN0xgWnnFC1Qd_346xDdgP2weQwYRtTxXEtoWDYupRkg67gH0P9jMNks9MF5Jhy1THUFe7wrGtwUwXeV5exTTlNOq9YZ5ArNusMQfiQwQ7T4S2-xjFNhx9fv4E9Yp9iTEdQy4xLXYb1OXridSzuxcN5jj7d3nzcvW_uPrzb767vGgsPEE3bCctMy4TtrPWy08q2g1fSaM6UM4SaThku1DAYSb03fEu2RCrBJNEtd5qfozen3DmnL4srtR9DsS5GPbm0lJ51LVVCKLkF9PU_6H1a8gTTASWFaokgDKiLE2VzKiU73885jPATPSX9r6p6qKr_XRWwrx4SFzO64S_5pxsArk7AMUS3_j-pv9ntT5E_AfK-obA</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Gołąb, Aleksandra</creator><creator>Plicner, Dariusz</creator><creator>Wypasek, Ewa</creator><creator>Natorska, Joanna</creator><creator>Kapelak, Bogusław</creator><creator>Plens, Krzysztof</creator><creator>Undas, Anetta</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3716-1724</orcidid><orcidid>https://orcid.org/0000-0003-4773-7512</orcidid><orcidid>https://orcid.org/0000-0003-3176-8007</orcidid><orcidid>https://orcid.org/0000-0002-3687-512X</orcidid></search><sort><creationdate>202207</creationdate><title>Impaired fibrin clot lysis is associated with increased mortality in patients after coronary artery bypass grafting: A long‐term follow‐up study</title><author>Gołąb, Aleksandra ; Plicner, Dariusz ; Wypasek, Ewa ; Natorska, Joanna ; Kapelak, Bogusław ; Plens, Krzysztof ; Undas, Anetta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-465c2b425c6ccf76a8c4df87ba328eb01b68b358ddb71ffb39090785270a43ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cardiovascular diseases</topic><topic>Cholesterol</topic><topic>clot lysis time</topic><topic>Coronary artery</topic><topic>Coronary Artery Bypass</topic><topic>coronary artery bypass grafting</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary vessels</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Fatalities</topic><topic>Fibrin</topic><topic>Fibrin - metabolism</topic><topic>Fibrin Clot Lysis Time</topic><topic>Fibrinogen</topic><topic>Fibrinolysis</topic><topic>Follow-Up Studies</topic><topic>follow‐up</topic><topic>Grafting</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Lysis</topic><topic>Mortality</topic><topic>Population studies</topic><topic>Regression analysis</topic><topic>Thromboembolism</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gołąb, Aleksandra</creatorcontrib><creatorcontrib>Plicner, Dariusz</creatorcontrib><creatorcontrib>Wypasek, Ewa</creatorcontrib><creatorcontrib>Natorska, Joanna</creatorcontrib><creatorcontrib>Kapelak, Bogusław</creatorcontrib><creatorcontrib>Plens, Krzysztof</creatorcontrib><creatorcontrib>Undas, Anetta</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gołąb, Aleksandra</au><au>Plicner, Dariusz</au><au>Wypasek, Ewa</au><au>Natorska, Joanna</au><au>Kapelak, Bogusław</au><au>Plens, Krzysztof</au><au>Undas, Anetta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impaired fibrin clot lysis is associated with increased mortality in patients after coronary artery bypass grafting: A long‐term follow‐up study</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2022-07</date><risdate>2022</risdate><volume>52</volume><issue>7</issue><spage>e13775</spage><epage>n/a</epage><pages>e13775-n/a</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>Background
Mortality after coronary artery bypass grafting (CABG) is primarily thromboembolic by nature. We investigated whether impaired fibrinolysis observed in cardiovascular diseases is associated with long‐term mortality following CABG.
Methods
The study population comprised 292 consecutive patients (aged 64.6 ± 8.1 years) who underwent scheduled CABG. We measured plasma clot lysis time (CLT) preoperatively as a measure of fibrinolysis capacity. Cardiovascular and all‐cause deaths were recorded during a median follow‐up of 13.8 years.
Result
CLT positively correlated with age (r = .56, p < .001), fibrinogen (r = .25, p = .002) and EuroSCORE I (r = .32, p < .001). The cardiovascular and overall mortality rates were 3.0 and 4.9 per 100 patient‐years (32.4% vs 52.8%) respectively. In patients who died from cardiovascular and all causes, CLT was prolonged compared with survivors (both p < .050). Multivariable Cox regression analysis adjusted for potential confounders showed that long‐term cardiovascular and all‐cause deaths were associated with CLT (HR per 10 min 1.206; 95% CI 1.037–1.402, p = .015 and HR 1.164; 96% CI 1.032–1.309, p = .012), low‐density lipoprotein cholesterol (HR per 1 mmol/L 1.556; 95% CI 1.205–2.010, p < .001 and HR 1.388; 96% CI 1.125–1.703, p = .002), C‐reactive protein (HR per 10 mg/L 1.171; 95% CI 1.046–1.312, p = .006 and HR 1.127; 95% CI 1.005–1.237, p = .022) and EuroSCORE I (HR 1.173; 95% CI 1.016–1.355, p = .030 and HR 1.183; 95% CI 1.059–1.317, p = .003 respectively). Type 2 diabetes was solely associated with overall mortality (HR 1.594; 96% CI 1.088–2.334, p = .017).
Conclusions
In this study, we showed that reduced fibrin clot susceptibility to fibrinolysis is weekly associated with long‐term mortality in advanced CAD.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>35313018</pmid><doi>10.1111/eci.13775</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3716-1724</orcidid><orcidid>https://orcid.org/0000-0003-4773-7512</orcidid><orcidid>https://orcid.org/0000-0003-3176-8007</orcidid><orcidid>https://orcid.org/0000-0002-3687-512X</orcidid></addata></record> |
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| subjects | Cardiovascular diseases Cholesterol clot lysis time Coronary artery Coronary Artery Bypass coronary artery bypass grafting Coronary Artery Disease - surgery Coronary vessels Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 Fatalities Fibrin Fibrin - metabolism Fibrin Clot Lysis Time Fibrinogen Fibrinolysis Follow-Up Studies follow‐up Grafting Heart surgery Humans Lysis Mortality Population studies Regression analysis Thromboembolism Treatment Outcome |
| title | Impaired fibrin clot lysis is associated with increased mortality in patients after coronary artery bypass grafting: A long‐term follow‐up study |
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