Increase in fibrinogenemia in the postoperative period of open-heart surgery.

Postoperative thromboses, with no effective prevention currently available, are a serious complication of open-heart surgery. Conventionally, anticoagulants (heparin, coumarine derivatives) are used after prosthetic heart valvular surgery (PHVS), and antiplatelet drugs (ASA) are administered after coronary artery by-pass graft operation (CABG)). Postoperative thrombophilia may be enhanced by an increase in plasma fibrinogen (FBG) levels, from 2.6 +/- 0.4 to 6.0 +/- 1.8 g/l, p < 0.01, as observed following open-heart surgery in CABG pts (n = 19), and from 2.8 +/- 0.5 to 4.2 +/- 1.0 g/l, p < 0.01) in PHVS pts (n = 12) during postoperative days 6 to 10. This increase in FBG in both groups of pts on different antithrombotic regimens significantly correlated with an increase in others plasma proteins alpha-1-antitrypsin A1AT (r = 0.43, p < 0.01), coeruloplasmin, CRPL (r = 0.53, p < 0.01), orosomucoid, ORM (r = 0.37, p < 0.02), and with prolongation of euglobulin clot lysis time (r = 0.42, p < 0.01) during the 21-day postoperative period. A negative correlation was demonstrated between FBG and the plasma levels of transferrin, TRF (r = -0.389, p < 0.02). Whereas FBG, ORM, A1AT, and CRPL are referred to as "positive" acute phase proteins, TRF is a "negative" acute phase protein. It follows from multivariate factor analysis that the reactive increase in these acute phase proteins (incl.FBG) is due to one "common" stimulating factor during the postoperative period. The "common" stimulating factor also raised thrombocyte count.(ABSTRACT TRUNCATED AT 250 WORDS)