Change in Platelet Lipid Metabolism and Procoagulant Phenotype Induced by Cardiopulmonary Bypass. Impact on Postoperative Inflammatory Response and Bleeding Complications During Cardiac Surgery.

Inclusion Criteria: * Adult patients (≥ 18 years old) suffering from coronary disease and/or severe valvular dysfunction (mitral or aortic) undergoing elective coronary angiography or cardiac surgery with cardiopulmonary bypass. Exclusion Criteria: * Uninterrupted preoperative dual antiplatelet therapy * Active chronic inflammatory disease * Recent chemotherapy or immunotherapy (\< 3 months) * Active solid malignancy * History of hematologic malignancy * Hemophilia or other coagulopathy * History of thrombocytopenia (\< 100,000 platelets/mm³) * Recent administration of thrombopoietin receptor agonist or immunoglobulins * History of thrombopathy, thrombocytosis, or myeloproliferative syndrome * History of heparin-induced thrombocytopenia (HIT) * Cirrhosis or hepatic fibrosis (with or without hypersplenism) * History of splenectomy, regardless of initial indication * History of systemic autoimmune disease (e.g., systemic lupus erythematosus, scleroderma, antiphospholipid syndrome, systemic vasculitis) * Recent major surgery (\< 3 months) * Severe renal insufficiency (eGFR ≤ 30 mL/min/m²) with or without dialysis * Recent or chronic corticosteroid therapy * Recent acute coronary syndrome, STEMI type (\< 3 months) * Urgent surgery or procedure * Preoperative hemodynamic instability