Cardiothoracic & vascular anaesthesia
Perioperative Antithrombin Activity and Postoperative Outcomes in Adult Cardiac Surgery: A Prospective Cohort in Contemporary Plasma-Sparing Practice
Authors' conclusion
In cardiac surgery patients where plasma was avoided and no AT supplementation was used, low perioperative AT activity was associated with higher unadjusted complication rates but did not independently predict outcomes after accounting for patient and procedural factors.
Study context
- Population
- Adults (≥18 years) undergoing cardiac surgery with CPB at two academic centres using factor concentrate-based hemostatic algorithms without routine antithrombin (AT) supplementation
- Participants
- 103 adults
- Exposure
- Lowest quintile vs higher quintiles of prebypass AT activity
- Outcome
- Co-primary: hospital and ICU LOS
- Follow-up
- To POD 28
Methodological detailsexploratory, observational, two-centre
- Exploratory
- Observational
- Two-centre
Main finding
As reported in the abstract
Hospital and ICU LOS
- Longer hospital stay in Q1 (unadjusted); prebypass AT status not an independent predictor in multivariable models
Observational data: associations, not effects.
Secondary outcomes
AKI and vasopressor/inotrope use beyond POD 1
- Higher rates in Q1 (unadjusted); prebypass AT status not an independent predictor in multivariable models
Postbypass AT levels
- Lower in Q1
Sensitivity analysis: postbypass AT threshold 63.7%
- Similar results
- Sensitivity analysis
Hemostatic therapy received
- Plasma
- 2 (2%)
- 4F-PCC
- 23%
- Fibrinogen concentrate
- 26%
Original publication
Perioperative Antithrombin Activity and Postoperative Outcomes in Adult Cardiac Surgery: A Prospective Cohort in Contemporary Plasma-Sparing Practice. J Cardiothorac Vasc Anesth. Published 24 September 2026. doi:10.
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