Perioperative coagulation activation after permanent pacemaker placement

Table 1 Baseline characteristics of patients included in the study, n (%)

Variable ( n = 146)		Data
Age, years		73 (67-81)
Body mass index, kg/m2		27.5 (25-31)
Gender
Male		77 (52.7)
Female		69 (47.3)
Pacemaker placement indication
Atrioventricular block		49 (33.6)
Sick sinus syndrome		47 (32.2)
Atrial fibrillation with impaired atrioventricular conduction		50 (34.2)
Comorbidity
Ischemic heart disease		146 (100)
Exertional angina		44 (30.1)
Arterial hypertension		143 (97.9)
Atrial fibrillation		96 (65.8)
Congestive heart failure		146 (100)
	NYHA Class I	7 (4.8)
	NYHA Class II	60 (41.1)
	NYHA Class III	79 (54.1)
	NYHA Class IV	0 (0)
History of myocardial infarction		28 (19.2)
History of stroke		12 (8.2)
Atherosclerotic peripheral arterial disease		4 (2.7)
Varicose veins		31 (21.2)
History of venous thromboembolism		8 (5.5)
Type 2 diabetes mellitus		39 (21.2)
History of coronavirus disease		4 (2.7)
Antithrombotic therapy
Antiplatelet therapy (aspirin)		55 (37.7)
Oral anticoagulants		91 (62.3)
	Rivaroxaban	57 (39)
	Apixaban	20 (13.7)
	Dabigatran etexilate	7 (4.8)
	Warfarin	7 (4.8)
Surgery features
Pacemaker
	Single-chamber	50 (34.2)
	Dual-chamber	96 (65.8)
Pacemaker placement side
	Left side	142 (97.3)
	Right side	4 (2.7)
Vascular access
	Cephalic vein (section)	132 (90.4)
	Subclavian vein (puncture)	14 (9.6)
Pacemaker pocket localization
	Above the pectoral fascia	133 (91.1)
	Inside the pectoralis major muscle	13 (8.9)
Mean surgery time, min		54 (41-60)

NYHA: New York Heart Association.

Table 2 Perioperative coagulation parameters (n = 146)

Variable	Before implantation	7 d after implantation	30 d after implantation	P value
FI	2.61 (2.05-3.11)	2.76 (2.08-3.42)	2.54 (2.16-2.91)	0.669
FII	157.9 (109.7-245.25)a	130 (86.8-192.5)	144.8 (103.31-185.6)	0.021
FV	147.7 (102.1-247.55)a,b	103.85 (60-161.6)	81.8 (67.15-130.65)	0.002
FVII	182.2 (85.1-344.8)	157.2 (99.1-259)	108.9 (74.9-219.8)	0.128
FVIII	80.4 (60.15-106.25)a,b	70.3 (48.5-89.1)	63.7 (41.6-88.25)	0.039
FIX	86.2 (70.75-102.95)a,b	75.4 (59.2-88.3)	73.9 (56.45-93.05)	0.014
FX	188.9 (99.3-308.18)a,b	158.9 (83.3-230)	127.2 (95.25-209.35)	0.022
FXI	82.6 (63.9-103.6)a,b	69.75 (53.8-97.6)	67.3 (54.25-98.05)	0.002
FXII	87.6 (67.15-102.3)a,b	78.9 (63.4-97.05)	81.2 (62.15-97.4)	< 0.001

^aP < 0.05 vs 7 d after pacemaker implantation.

^bP < 0.05 vs 30 d after pacemaker implantation.

FI: Factor I; FII: Factor II; FV: Factor V; FVII: Factor VII; FVIII: Factor VIII; FIX: Factor IX; FX: Factor X; FXI: Factor XI; FXII: Factor XII.

Table 3 Perioperative coagulation parameters in patients on antiplatelet (n = 55) and anticoagulant (n = 91) therapy

Variable	Antithrombotic therapy	Before implantation	7 d after implantation	30 d after implantation	P value
FI	Antiplatelet	2.66 (2.13-2.99)	2.85 (2.47-3.3)	2.56 (2.19-3.16)	0.513
	Anticoagulant	2.55 (1.9-3.19)	2.58 (1.93-3.44)	2.49 (2.16-2.85)	0.957
	P value	0.675	0.092	0.599	-
FII	Antiplatelet	156.9 (94.5-237.3)	139 (86.8-192.5)	163.5 (112.4-203)	0.289
	Anticoagulant	186.2 (113.8-256.8)	118.5 (86.8 -173)	128.4 (99.6-170.5)	0.067
	P value	0.458	0.609	0.263	-
FV	Antiplatelet	164.9 (103.4-267.5)	115.5 (92.8-198.9)	98.6 (82.6-155.3)	0.245
	Anticoagulant	133.3 (96.6-187.9)a,b	80.1 (45.9-152.8)	73.4 (55.4-84.3)	0.005
	P value	0.196	0.033	0.004	-
FVII	Antiplatelet	203.4 (113-352.1)	200 (116.4-438.3)	223 (107.9-376.6)	0.683
	Anticoagulant	182.1 (87.3-384.6)	122.3 (80.3-209.9)	83.7 (64.6-154.8)	0.153
	P value	0.691	0.024	0.002	-
FVIII	Antiplatelet	82.1 (62.5-114.3)	81.6 (63.8-97.5)	75.5 (59.1-100.5)	0.104
	Anticoagulant	78.5 (58.7-99.7)a,b	59.6 (41.7-82)	55.1 (40.8-84.4)	0.001
	P value	0.21	0.001	0.033	-
FIX	Antiplatelet	85.4 (74.8-106.9)	84.2 (78-105.8)	96.7 (87.2-104)	0.438
	Anticoagulant	87 (68.4-99.6)a,b	69.6 (55.6-81.8)	63.2 (45.5-76.8)	0.004
	P value	0.331	<0.001	<0.001	-
FX	Antiplatelet	200 (105.8-308.2)	163.8 (81.7-228.4)	171.6 (120.2-240)	0.708
	Anticoagulant	187.8 (98.6-286.1)a,b	152.6 (89-248.2)	109.8 (82-163.5)	0.007
	P value	0.837	0.983	0.03	-
FXI	Antiplatelet	87.2 (69.8-100.8)	93.8 (63.1-108.2)	96.7 (84.2-108)	0.957
	Anticoagulant	74.8 (62.5-106.9)a,b	61 (49.9-82.6)	59.5 (47.5-86.5)	< 0.001
	P value	0.377	0.001	< 0.001	-
FXII	Antiplatelet	82 (65.8-101.9)a	79.9 (63.3-97.1)	89.7 (75.7-102.5)	0.01
	Anticoagulant	80.7 (69.4-110.2)a,b	78.9 (63.4-97)	73.8 (69.8-90.3)	0.001
	P value	0.989	0.629	0.027	-

^aP < 0.05 vs 7 d after pacemaker implantation.

^bP < 0.05 vs 30 d after pacemaker implantation.

FI: Factor I; FII: Factor II; FV: Factor V; FVII: Factor VII; FVIII: Factor VIII; FIX: Factor IX; FX: Factor X; FXI: Factor XI; FXII: Factor XII.