Thrombin activatable fibrinolysis inhibitor (TAFI) in stable angina pectoris patients undergoing coronary artery bypass grafting (CABG)

Lisowski P, Małyszko J, Hirnle T, Lisowska A, Jackowski R, Mayszko JS, Buzun L, Myśliwiec M

Abstract

Purpose: Thrombin activatable fibrinolysis inhibitor (TAFI) seems to be a potential haemostatic risk factor of coronary artery disease (CAD). Taking into account interactions between TAFI and haemostasis, especially during cardiopulmonary bypass, we decided to determine concentration of TAFI and activated TAFI (TAFIa) and other haemostasis markers in CABG patients.
Material and methods: 45 CAD patients (11 women, 34 men) undergoing elective CABG were included in the study. Blood samples were taken before the operation, on the 3rd, 7th day and 3 months after CABG. A value of p<0.05 was considered statistically significant.
Results: We found a significant decrease in TAFIa concentration on 3rd postoperative day: 6 g/ml (0.3-43.2) vs 8.9 g/ml (0.5-37) before CABG (p<0.05), a significant increase in TAFI concentration on the 7th postoperative day: 127.7%±36.8 vs 112.18%±30.34 of standard plasma concentration before CABG (p<0.05), significant increase in plasmin-antyplasmin (PAP) complexes concentration on 3rd and 7th day, respectively: 645 g/l (323-1237) vs 406 g/l (197-1840) before CABG (p<0.001); and 1 030 g/l (640-2 149) vs 406 g/l (197-1840) before CABG (p<0.0001). Before operation we found a significant negative correlation between PAP complexes concentration before CABG and EuroSCORE risk scale value (p<0.01). 
Conclusions: In CABG patients, there is a significant increase in fibrinolytic activity due to decrease in TAFIa concentration, with simultaneous increase in PAP complexes. A significant negative correlation between PAP complexes concentration before CABG and EuroSCORE risk scale value stressed a potentially higher operation risk in patients with lower fibrinolytic activity.

Key words: 	thrombin activatable fibrinolysis inhibitor (TAFI), coronary artery bypass grafting (CABG), coronary artery disease (CAD), haemostasis.