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

M.J. Adams; R.A. Cardigan; W.A. Marchant; M.P.W. Grocott; M.G. Mythen; M. Mutch; G. Purdy; I.J. Mackie; S.J. Machin

doi:10.1053/jcan.2002.29677

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

Journal article

Peer reviewed

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

M.J. Adams, R.A. Cardigan, W.A. Marchant, M.P.W. Grocott, M.G. Mythen, M. Mutch, G. Purdy, I.J. Mackie and S.J. Machin

Journal of Cardiothoracic and Vascular Anesthesia, Vol.16(1), pp.59-63

2002

DOI: https://doi.org/10.1053/jcan.2002.29677

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Abstract

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 (<300 ng/mL) postheparin levels of TFPI antigen that were not associated with low functional TFPI or adverse clinical outcome. Fourteen patients showed a low ratio of increased functional TFPI postheparin; all had a ratio of TFPI antigen increase of at least 3-fold. Conclusion: The TFPI response to heparin is heterogenous. Two nonresponders were identified, with low postheparin levels of TFPI antigen, who did not suffer adverse clinical outcomes.

Details

Title: Tissue factor pathway inhibitor antigen and activity in 96 patients receiving heparin for cardiopulmonary bypass
Authors/Creators: M.J. Adams (Author/Creator) - University College London
R.A. Cardigan (Author/Creator) - University College London
W.A. Marchant (Author/Creator) - University College London
M.P.W. Grocott (Author/Creator) - University College London
M.G. Mythen (Author/Creator) - University College London
M. Mutch (Author/Creator) - University College London
G. Purdy (Author/Creator) - University College London
I.J. Mackie (Author/Creator) - University College London
S.J. Machin (Author/Creator) - University College London
Publication Details: Journal of Cardiothoracic and Vascular Anesthesia, Vol.16(1), pp.59-63
Publisher: Elsevier Science (USA)
Identifiers: 991005542469707891
Copyright: © 2002 Published by Elsevier Inc.
Murdoch Affiliation: Murdoch University
Language: English
Resource Type: Journal article

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Citation topics: 1 Clinical & Life Sciences; 1.75 Blood Clotting; 1.75.1434 Coagulation Pathways
Web Of Science research areas: Anesthesiology; Cardiac & Cardiovascular Systems; Peripheral Vascular Disease; Respiratory System
ESI research areas: Clinical Medicine