INTRODUCTION
The coronary artery bypass graft (CABG) procedure is among the most
common cardiac surgical procedures.1,2 It has become
the final treatment to reduce symptoms and mortality in subjects with
ischemic heart disease resulting from multivessel coronary artery
disease (CAD) or left-main disease for >40
years.3 Older age, female gender, the presence of
obesity, diabetes, hypertension, chronic obstructive pulmonary disease,
extra-cardiac arteriopathy, neurologic dysfunction, left-main stem
disease, renal dysfunction, reduced left ventricular ejection fraction,
and the development of perioperative myocardial infarction and atrial
fibrillation are among the factors shown to increase in-hospital
mortality in patients undergoing CABG.4
Excessive bleeding is another important risk factor for in-hospital
mortality after CABG. Consumption of coagulation factors, and impaired
platelet function are responsible for about half of the postoperative
bleeds and re-explorations following CABG.5 In
addition to an increase in in-hospital mortality, the need for blood
transfusions as a result of excessive bleeding prolongs hospital stay
and increases healthcare costs.
The number of immature platelets (IP) and immature platelet fraction
(IPF) may provide clues concerning the status of platelet function.
Immature platelets are young cells that have recently been released into
the circulation, and are considered indicators of bone marrow
recovery.6 The IP count (IPC) and IPF values may be
used as a representation of the number of recently produced platelets
released into the circulation by regenerated BM megakaryocytes, thereby
reflecting the level of thrombopoiesis.7 Platelet
dysfunction has been shown to play a role in postoperative bleeding;
however, there is very little data pertaining to the role of these
immature thrombocytes in the induction of sufficient homeostasis and the
prevention of excessive bleeding following CABG.
The purpose of this study was to investigate IPC, IPF and mean platelet
volume (MPV) values throughout the hospitalization of patients
undergoing CABG in order to elucidate whether they were associated with
postoperative bleeding and the need for transfusion.