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A Comparison of Aprotinin and Lysine Analogues in High-Risk Cardiac Surgery
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A Comparison of Aprotinin and Lysine Analogues in High-Risk Cardiac Surgery
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Journal Article
A Comparison of Aprotinin and Lysine Analogues in High-Risk Cardiac Surgery
2008
Overview
In this clinical trial involving patients undergoing high-risk cardiac surgery, aprotinin was somewhat more effective than either aminocaproic acid or tranexamic acid in reducing massive perioperative bleeding but at the expense of a higher rate of death, mainly from cardiac causes. Aprotinin cannot be recommended to control blood loss in this clinical setting.
In patients undergoing high-risk cardiac surgery, aprotinin was somewhat more effective than either aminocaproic acid or tranexamic acid in reducing massive perioperative bleeding but at the expense of a higher rate of death, mainly from cardiac causes.
Every year an estimated 1 million to 1.25 million patients worldwide undergo cardiac surgery, including high-risk procedures such as repeat coronary-artery bypass grafting (CABG), valve replacements, and combined procedures.
1
High-risk procedures present an increased risk of death, massive bleeding, renal failure, and thrombotic complications, as compared with first-time isolated CABG.
2
–
4
Three antifibrinolytic agents have been used in cardiac surgery to minimize bleeding and reduce the need for transfusion: aprotinin, a naturally occurring serine protease inhibitor, and two lysine analogues, tranexamic acid and aminocaproic acid.
5
In clinical trials, all three drugs have been shown to be effective in reducing the . . .
Publisher
Massachusetts Medical Society
Subject
/ Aged
/ Aminocaproates - adverse effects
/ Aminocaproates - therapeutic use
/ Antifibrinolytic Agents - adverse effects
/ Antifibrinolytic Agents - therapeutic use
/ Biological and medical sciences
/ Blood Transfusion - statistics & numerical data
/ Cardiac Surgical Procedures - mortality
/ Female
/ Humans
/ Lysine - analogs & derivatives
/ Male
/ Postoperative Hemorrhage - epidemiology
/ Postoperative Hemorrhage - prevention & control
/ Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
/ Tranexamic Acid - adverse effects
