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The purpose of this study is to evaluate the effects of remote ischemic conditioning on platelet function during off-pump coronary artery bypass surgery.
Remote ischemic conditioning (RIC) may affect platelet function. However, little is known about effect of RIC on platelet function during off-pump coronary artery bypass surgery. In this study investigators are going to perform RIC after anesthesia induction (remote ischemic pre-conditioning) and after completion of coronary anastomoses (remote ischemic post-conditioning), and compare platelet function parameters with control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Remote ischemic conditioning | Experimental | Applying pneumatic cuff on upper extremity (5 minutes cycles of limb ischemia and reperfusion with pneumatic cuff up to 200 mmHg repeated by four times) before and after coronary anastomoses. |
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| Control | Placebo Comparator | All the procedures were the same in the control group, except for the fact that the three-way stopcock between the pneumatic cuff and the cuff inflator was opened and therefore the cuff pressure did not increase. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Remote ischemic conditioning | Procedure | In the RIC group, RIC is performed before and after coronary anastomoses by 5 minutes limb ischemia and reperfusion with pneumatic cuff up to 200 mmHg repeated by four times. |
| Measure | Description | Time Frame |
|---|---|---|
| Change of Multiplate ADPtest AUC | Area under the aggregation curve (AUC) after platelet stimulation with adenosine diphosphate | Baseline, at the end of surgery, postoperative day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Change of Multiplate ASPItest AUC | Area under the aggregation curve (AUC) after platelet stimulation with arachidonic acid | Baseline, at the end of surgery, postoperative day 1 |
| Change of Multiplate COLtest AUC |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yunseok Jeon, M.D., Ph. D. | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 03080 | South Korea |
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| Control | Procedure | In the control group, all the procedures will be same with RIC group, except for the fact that the three-way stopcock between the pneumatic cuff and the cuff inflator was opened and therefore the cuff pressure did not increase. |
|
Area under the aggregation curve (AUC) after platelet stimulation with collagen
| Baseline, at the end of surgery, postoperative day 1 |
| Change of Rotational thromboelastometry EXTEM parameter | Screening test for the extrinsic haemostasis system | Baseline, at the end of surgery, postoperative day 1 |
| Change of Rotational thromboelastometry FIBTEM parameter | Represents an EXTEM based assay for the fibrin part of the clot | Baseline, at the end of surgery, postoperative day 1 |
| Rotational thromboelastometry INTEM parameter | Intrinsically activated rotational thrombelastometry | Baseline, at the end of surgery, postoperative day 1 |
| Change of Rotational thromboelastometry HEPTEM parameter | Represents an INTEM assay performed in the presence of heparinase | Baseline, at the end of surgery, postoperative day 1 |
| Amount of peri-operative bleeding and transfusion | Amount of peri-operative bleeding and transfusion | At the end of surgery, postoperative day 1,2,3 |