Long-term alcoholic patients have decreased perioperative cAMP levels

Background

Patients with chronic alcohol misuse have an increased risk of postoperative bleeding complications compared with non-alcoholic individuals [1]. Serotonin increases [2], and cAMP and cyclic guanosine monophosphate (cGMP) decrease, platelet aggregation [3]. The aim of our study was to examine platelet-rich plasma levels of the mentioned substances in long-term alcoholic patients undergoing surgery.

Methods

We included 33 consecutive patients with chronic alcohol misuse scheduled for tumor resections of the upper digestive tract and postoperative intensive care. We defined long-term alcoholic patients as having a daily alcohol intake of at least 60 g and fulfilling the DSM-IV criteria of the American Psychiatric Association for alcohol abuse or dependence. Blood samples were collected before and 1 day after surgery. Serotonin was measured by ELISA, cAMP and cGMP by radioimmunoassay. Additionally, we measured standard coagulation tests and determined platelet aggregation induced by ADP, collagen, epinephrine and ristocetin before and after surgery. Statistics: Mann-Whitney U test.

Results

Basic patient characteristics and platelet aggregation responses induced by the mentioned agonists did not significantly differ. Data are presented in Table 1.

Table 1 abstract P236

Conclusion

In contrast to previous studies, there were no significantly altered aggregation responses in long-term alcoholic patients. A possible explanation might be the decreased inhibition through diminished cAMP levels. Our findings may suggest that cGMP and serotonin do not influence the perioperative hemostasis.