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.