Preoperative Cholesterol and Thrombotic Complications after Coronary Bypass

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.