Evidence map›Paper›PMID 41528430›Full record

Observational studyJournal of anesthesia2026

Postoperative reduction in thrombin generation induced by elevated levels of tissue factor pathway inhibitor in cardiac surgery: a prospective observational study.

Akiko Kitajo, Nobuyo Umehara, Aya Takemoto, Yudai Yamamoto, Yoshiki Sento, Tomoyuki Fujita, Tokujiro Uchida

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Reply to the letter by Dong et al.Journal of anesthesia · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Akiko KitajoDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Nobuyo UmeharaDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Aya TakemotoDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Yudai YamamotoDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Yoshiki SentoDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Tomoyuki FujitaDepartment of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Tokujiro UchidaDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan. uchida.mane@tmd.ac.jp.ORCID http://orcid.org/0000-0002-9474-0020

Funding

Japan Society for the Promotion of Science JP23H03001Japan Society for the Promotion of Science JP23K27692
6 · The paper itself

Abstract

purposeTissue factor pathway inhibitor (TFPI) is an intrinsic anticoagulant factor, and its plasma concentration is elevated by heparin administration. Because several hours are required to return to normal range after heparin reversal, we investigated the role of TFPI in the inhibition of thrombin generation (TG) in patients undergoing cardiac surgery.

methodsBlood samples were collected from adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) before, at the end of, and 1 day after surgery. Plasma concentration of TFPI, peak height of the TG assay (peak TG), and whole blood coagulation time by dielectric blood coagulometry using a Russell's viper venom cartridge system were evaluated. Nonparametric correlation was evaluated using Spearman's method, and time-dependent change was analyzed using repeated measures analysis of variance.

resultsThe plasma concentration of TFPI was higher (54 [47-60] ng/mL vs. 18 [13-27] ng/mL; P < 0.001) and the peak TG value was lower (98.1 [48.9-148] nM vs. 268 [244-309]; P < 0.001) at the end of surgery than before surgery. Plasma TFPI concentration showed a positive correlation with whole blood coagulation time as measured by dielectric blood coagulometry (Rs = 0.643) and a negative correlation with peak TG (Rs =  - 0.624). Anti-TFPI antibody neutralized reduction in peak TG.

conclusionsIn patients undergoing cardiac surgery using CPB, the increase in plasma TFPI concentration at the end of surgery causes a reduction in TG and impairment of whole blood coagulation via a mechanism that includes inhibition of factor Xa activity.

Indexed as

Cardiac Surgical ProceduresLipoproteinsThrombinAgedBlood CoagulationBlood Coagulation TestsCardiopulmonary BypassFemaleHumansMaleMiddle AgedPostoperative PeriodProspective Studieslipoprotein-associated coagulation inhibitorLipoproteinsThrombinCardiac surgeryThrombin generationTissue factor pathway inhibitor

Identifiers

PMID41528430
PMCPMC13623792

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.