CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1595027
This article is part of the Research TopicExploring New Frontiers in Heart Surgery: Case Studies 2025View all 21 articles
Antithrombotic Management in an Elderly CABG Patient with Nephrotic Syndrome: A Case Report
Provisionally accepted
- 1Ningbo Second Hospital, Ningbo, Zhejiang Province, China
- 2Department of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 3Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
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Coronary artery bypass grafting (CABG) is a common treatment for coronary artery disease (CAD), but it poses significant perioperative risks, including thrombosis and bleeding, especially in elderly patients with comorbidities such as nephrotic syndrome and pulmonary infection. Thromboelastography (TEG) has emerged as a valuable tool for guiding dual antiplatelet therapy (DAPT) and optimizing drug treatment strategies in these complex cases. A case presentation of a 65-year-old male patient with nephrotic syndrome and pulmonary infection undergoing CABG surgery was reported. The patient's management included TEG-guided DAPT, routine monitoring of coagulation parameters, and adjustments based on clinical findings and laboratory results. TEG effectively guided DAPT and anticoagulant therapy, ensuring appropriate coagulation status and minimizing bleeding risks. The patient's postoperative management included dual antiplatelet therapy with aspirin and clopidogrel, adjusted based on TEG results. Additional interventions included the use of proton pump inhibitors to prevent gastrointestinal bleeding and tailored antibiotic therapy for pulmonary infection. The patient's clinical outcomes improved, with stable coagulation parameters and controlled infection. Clinical pharmacists play a critical role in optimizing medication regimens and ensuring patient safety through multidisciplinary collaboration. Future studies should further explore the integration of TEG and other advanced tools in personalized pharmaceutical care for complex post-CABG cases.
Keywords: coronary artery bypass grafting, Nephrotic Syndrome, Thromboelastography, Pharmacists, pharmaceutical care
Received: 17 Mar 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Xu, Li, Chen, Zhao, Zhu and Kai-Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jian-Ping Zhu, zjping@zju.edu.cn
Mao Kai-Li, 1258371506@wmu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.