Remote Ischemic Conditioning and Platelet Dysfunction

Effect of Remote Ischemic Conditioning on Platelet Dysfunction Following Off-pump Coronary Artery Bypass Surgery

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.

Inclusion Criteria:

• 20 - 80 years of adult patient undergoing elective off-pump coronary artery bypass surgery

Exclusion Criteria:

• Acute Myocardial Infarction
• Recent (<1 month) coronary angioplasty (percutaneous coronary intervention, PCI)
• Acute cerebrovascular ischemia (<6 months)
• Preoperative LV EF < 30%, mechanical ventricular support (IABP, VAD, ECMO)
• Peripheral vascular disease
• Poorly controlled diabetes mellitus
• Alzheimer's disease
• NSAIDs within 3 days
• iv heparin within 6 h
• low molecular weight heparin within 24 h
• platelet inhibitor within 24 h
• known thrombocytopenia
• renal failure / hemodialysis
• active infection
• preoperative bleeding diathesis
• redo-operation
• pregnancy