Low dose aprotinin and low dose tranexamic acid in elective cardiac surgery with cardiopulmonary bypass

Clinical Hemorheology and Microcirculation

Volumn 42, Issue 4, 2009, Pages 269-277

  Waldow, Thomas ^a   Krutzsch, Diana ^a   Wils, Michael ^a   Plötze, Katrin ^a   Matschke, Klaus ^a  

^a University Heart Center Dresden   (Germany)

Author keywords

Antifibrinolytic agent; Aprotinin; Cardiopulmonary bypass; Elective cardiac surgery; Tranexamic acid

Indexed keywords

APROTININ; TRANEXAMIC ACID;

ARTICLE; BLOOD TRANSFUSION; CARDIOPULMONARY BYPASS; CLINICAL TRIAL; DRUG EFFICACY; DRUG SAFETY; ELECTIVE SURGERY; HEART SURGERY; HUMAN; LOW DRUG DOSE; META ANALYSIS; PERIOPERATIVE COMPLICATION; POSTOPERATIVE CARE; POSTOPERATIVE COMPLICATION; POSTOPERATIVE HEMORRHAGE; SURGICAL MORTALITY; SYSTEMATIC REVIEW;

AGED; APROTININ; BLOOD TRANSFUSION; CARDIAC SURGICAL PROCEDURES; CARDIOPULMONARY BYPASS; FEMALE; HEMOSTATICS; HUMANS; MALE; MIDDLE AGED; POSTOPERATIVE HEMORRHAGE; PROSPECTIVE STUDIES; SURGICAL PROCEDURES, ELECTIVE; TRANEXAMIC ACID;

EID: 68649102558     PISSN: 13860291     EISSN: None     Source Type: Journal    
DOI: 10.3233/CH-2009-1197     Document Type: Article

References (29)

1. R.W. Barrons and J.S. Jahr, A review of post-cardiopulmonary bypass bleeding, aminocaproic acid, tranexamic acid, and aprotinin, Am. J. Ther. 3 (1996), 821-838.
2. J.R. Brown, N.J.O. Birkmeyer and G.T. O'Connor, Meta-analysis comparing the effectiveness and adverse outcomes of antifibrinolytic agents in cardiac surgery, Circulation 115 (2007), 2801-2813.
3. V. Casati, L. Galli and A. D'Angelo, Aprotinin and renal risk in cardiac surgery, Transfusion 46 (2006), 2207 (Letter).
4. W. Dietrich, A. Ebell, R. Busley and A.-L. Boulesteix, Aprotinin and anaphylaxis: analysis of 12,403 exposures to aprotinin in cardiac surgery, Ann. Thorac. Surg. 84 (2007), 1144-1150.
5. W. Dietrich, M. Spannagel, J. Boehm, K. Hauner, S. Braun, T. Schuster and R. Busley, Tranexamic acid and aprotinin in primary cardiac operations: an analysis of 220 cardiac surgical patients treated with tranexamic acid or aprotinin, Anesth. Analg. 107(5) (2008), 1469-1478.
6. L. Englberger, P. Markart, F.S. Eckstein, F.F. Immer, P.A. Berdat and T.P. Carrel, Aprotinin reduces blood loss in off-pump coronary artery bypass (OPCAB) surgery, Eur. J. Cardiothor. Surg. 22 (2002), 545-551.
7. V.A. Ferraris, C.R. Bridges and R.P. Anderson, Aprotinin in cardiac surgery, N. Engl. J. Med. 354 (2006), 1953-1954 (Letter).
8. S.E. Fremes, B.I. Wong, E. Lee, R. Mai, G.T. Christakis, R.F. McLean, B.S. Goldman and C.D. Naylor, Meta-analysis of prophylactic drug treatment in the prevention of postoperative bleeding, Ann. Thorac. Surg. 58 (1994), 1580-1588.
9. A.P. Furnary, Y.X. Wu, L.F. Hiratzka, G.L. Grunkemeier and U. Scott Page 3rd, Aprotinin does not increase the risk of renal failure in cardiac surgery patients, Circulation 116(Suppl. I) (2007), I127-I133.
10. J.J. Gagne, D.E. Griesdale and S. Schneeweiss, Aprotinin and the risk of death and renal dysfunction in patients undergoing cardiac surgery: a meta-analysis of epidemiologic studies, Pharmacoepidemiol. Drug Saf. 18(4) (2009), 259-268.
11. D. Henry, P. Carless, D. Fergusson and A. Laupacis, The safety of aprotinin and lysine-derived antifibrinolytic drugs in cardiac surgery: a meta-analysis, CMAJ 180(2) (2009), 183-193.
12. D.A. Henry, P.A. Carless, A.J. Moxey, D. O'Connell, B.J. Stokes, B. McClelland, A. Laupacis and D. Fergusson, Antifibrinolytic use for minimizing perioperative allogeneic blood transfusion, Cochrane Database Syst. Rev. 4 (2007), Art. No. CD001886; doi: 10.1002/14651858.CD001886.pub2.
13. K. Karkouti, W.S. Beattie, K.M. Datillo, S.A. McCluskey, M. Ghannam, A. Hamdy, D.N. Wijeysundera, L. Fedorko and T.M. Yau, A propensity score case-control comparison of aprotinin and tranexamic acid in high-transfusion- risk cardiac surgery, Transfusion 46 (2006), 327-338.
14. M. Kluth, J.U. Lueth, A. Zittermann, M. Lanzenstiel, R. Koerfer and K. Inoue, Safety of low-dose aprotinin in coronary artery bypass graft surgery: a single-centre investigation in 2436 patients in Germany, Drug Saf. 31(7) (2008), 617-626.
15. A. Laupacis and D. Fergusson, Drugs to minimize perioperative blood loss in cardiac surgery: Meta-analyses using peri-operative blood transfusion as the outcome, Anesth. Analg. 85 (1997), 1258-1267.
16. D.T. Mangano, Y. Miao, A. Vuylsteke, I.C. Tudor, R. Juneja, D. Filipescu, A. Hoeft, M.L. Fontes, Z. Hillel, E. Ott, T. Titov, C. Dietzel and J. Levin, Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery, JAMA 297 (2007), 471-479.
17. D.T. Mangano, J.C. Tudor and C. Dietzel, The risk associated with aprotinin in cardiac surgery, N. Eng. J. Med. 354 (2006), 353-365.
18. R. Mouton, D. Finch, I. Davies, A. Binks and K. Zacharowski, Effect of aprotinin on renal dysfunction in patients undergoing on-pump and off-pump cardiac surgery: a retrospective observational study, Lancet 371 (2008), 475-482.
19. G.J. Murphy, E. Mango, V. Lucchetti, F. Battaglia, D. Catapano, C.A. Rogers and G.D. Angelini, A randomized trial of tranexamic acid in combination with cell salvage plus a meta-analysis of randomized trials evaluating tranexamic acid if off-pump coronary artery bypass grafting, J. Thorac. Cardiovasc. Surg. 132 (2006), 475-480.
20. R.S. Poston, C. White, J. Gu, J. Brown, J. Gammie, R.N. Pierson, A. Lee, I. Connerney, T. Avari, R. Christenson, U. Tandry and B.P. Griffith, Aprotinin shows both hemostatic and antithrombotic effects during off-pump coronary artery bypass grafting, Ann. Thorac. Surg. 81 (2006), 104-111.
21. S.C. Pugh and A.K. Wielogorski, A comparison of the effects of tranexamic acid and low-dose aprotinin on blood loss and homologous blood usage in patients undergoing cardiac surgery, J. Cardiothor. Vasc. Anesth. 9 (1995), 240-244.
22. D. Royston and A. Chhatwani, Safety aspects of aprotinin therapy in cardiac surgery patients, Exp. Opin. Drug Saf. 5 (2006), 539-552.
23. T. Sagesaka, H. Juen and M. Hayashi, Influence of red blood cell concentration on the initiation time of blood coagulation: risk of thrombus formation in pregnant females with anemia, Clin. Hemorheol. Microcirc. 36(2) (2007), 155-161.
24. E.S. Schouten, A.C. van de Pol, A.N. Schouten, N.M. Turner, N.J. Jansen and C.W. Bollen, The effect of aprotinin, tranexamic acid, and aminocaproic acid on blood loss and use of blood products in major pediatric surgery: A meta-analysis, Pediatr. Crit. Care Med. 10(2) (2009), 182-190.
25. A. Sedrakyan, D. Atkins and T. Treasure, The risk of aprotinin: a conflict of evidence, Lancet 367 (2006), 1376-1377.
26. A. Sedrakyan, T. Treasure and J.A. Elefteriades, Effect of aprotinin on clinical outcomes in coronary artery bypass graft surgery: a systematic review and meta-analysis of randomized clinical trials, J. Thorac. Cardiovasc. Surg. 128 (2004), 442-448.
27. A.D. Shaw, M. Stafford-Smith, W.D. White, B. Phillips-Bute, M. Swaminathan, C. Milano, I.J. Welsby, S. Aronson, J.P. Mathew, E.D. Peterson and M.F. Newman, The effect of aprotinin on outcome after coronary-artery bypass grafting, N. Engl. J. Med. 358(8) (2008), 784-793.
28. R.G. Speekenbrink, A.B. Vonk, C.R. Wildevuur and L. Eijsman, Hemostatic efficacy of dipyridamole, tranexamic acid, and aprotinin in coronary bypass grafting, Ann. Thorac. Surg. 59 (1995), 438-442.
29. T. Vanek, M. Jares, R. Fajt, Z. Straka, K. Jirasek, M. Kolesar, P. Brucek and M. Maly, Fibrinolytic inhibitors in off-pump coronary surgery: a prospective, randomized, double-blind TAP study (tranexamic acid, aprotinin, placebo), Eur. J. Cardiothor. Surg. 28 (2005), 563-568.