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Preoperative Cholesterol and Thrombotic Complications After Coronary Bypass

Department of Cardiovascular Surgery and Cardiology Hôpital de la Tour Geneva, Switzerland

For reprint information contact: Jan T Christenson, MD Tel: 41 22 372 7872 Fax: 41 22 372 7634 email: jtchristenson{at}hotmail.com Department of Surgery, Clinic for Cardiovascular and Thoracic Surgery, University Hospital, rue Micheli-du-Crest 24, Geneva 14 CH-1211, Switzerland.

The relationship between preoperative lipid status and postoperative thrombocytosis was evaluated in 130 patients who were grouped according to their preoperative serum cholesterol level: group A, cholesterol 6.2 mmol•L^–1 (n = 40); group B, cholesterol < 6.2 but 5.2 mmol•L^–1 (n = 22); group C, cholesterol < 5.2 but 4.7 (n = 18); and group D, cholesterol < 4.7 mmol•L^–1 (n = 50). Patient demo-graphics, angiography findings, and operative data did not differ between the groups. The incidence of postoperative thrombocytosis (platelet count 400,000/µL) was 82.5%, 36.4%, 16.7%, and 2.0% for groups A to D, respectively. Patients who developed thrombocytosis had a significantly higher preoperative ratio of total cholesterol to high-density lipoprotein cholesterol than those with normal platelet counts. The incidence of thrombocytosis directly correlated with the preoperative total cholesterol level. A distinct separation point seems to be a total cholesterol level of 4.7 mmol•L^–1. Preoperative lipid control with statins is emphasized to avoid postoperative thrombocytosis and thrombotic complications. The total cholesterol/high-density lipoprotein cholesterol ratio seems to be the best indicator of the risk of developing postoperative thrombocytosis.