Tissue factor pathway inhibitor antigen and activity in 96 patients receiving heparin for cardiopulmonary bypass

Objective: To identify patients with poor tissue factor pathway inhibitor (TFPI) response to heparin and observe any association with increased risk of excessive coagulation activation, morbidity, or mortality. Design: Prospective, observational cohort study. Setting: University hospital. Participan...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2002-02, Vol.16 (1), p.59-63
Main Authors: Adams, Murray J., Cardigan, Rebecca A., Marchant, Warwick A., Grocott, Michael P.W., Mythen, Monty G., Mutch, Maj, Purdy, Gordon, Mackie, Ian J., Machin, Samuel J.
Format: Article
Language:English
Subjects:
Adolescent
Aged
Aged, 80 and over
Anesthesia
Anesthesia depending on type of surgery
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anticoagulants - blood
Anticoagulants - therapeutic use
Biological and medical sciences
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Cohort Studies
Factor Xa Inhibitors
Female
heparin
Heparin - blood
Heparin - therapeutic use
Humans
Lipoproteins - blood
Male
Medical sciences
Middle Aged
Prospective Studies
Thoracic and cardiovascular surgery. Cardiopulmonary bypass
thrombosis
tissue factor pathway inhibitor (TFPI)
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Summary:Objective: To identify patients with poor tissue factor pathway inhibitor (TFPI) response to heparin and observe any association with increased risk of excessive coagulation activation, morbidity, or mortality. Design: Prospective, observational cohort study. Setting: University hospital. Participants: Patients (n = 96) undergoing cardiopulmonary bypass for various types of surgery. Interventions: None. Measurements and Main Results: TFPI antigen and activity were determined in patients before and after heparin administration, before cardiopulmonary bypass for cardiac surgery. The clinical progress of each patient was recorded. Median levels of TFPI activity were 0.98 U/mL (interquartile range, 0.83 to 1.14 U/mL) preheparin and 2.34 U/mL (2.18 to 2.54 U/mL) postheparin (p < 0.0001), representing a median 2.3-(2.1- to 2.8-) fold increase. Median TFPI antigen levels were 92.4 ng/mL (73.0 to 119.5 ng/mL) preheparin and 422.9 ng/mL (398.7 to 501.6 ng/mL) postheparin (p < 0.0001), representing a median 4.6-fold (3.6- to 6.2-fold) increase. Two patients had low (
ISSN:1053-0770
1532-8422
DOI:10.1053/jcan.2002.29677