Tranexamic Acid for Routine Use in Off-Pump Coronary Artery Bypass Surgery

Martin, Janet; Cheng, Davy

doi:10.1213/ane.0b013e31825b6746

Cited by 8 publications

(2 citation statements)

References 37 publications

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“…Second, we included only low-risk patients in this study, which is likely not the population that will benefit most from intensified antifibrinolytic therapy. 28 Our study population was a very homogenous class of patients, in which assessment of the plasmatic concentration could be well performed although the design of the study did not allow a full PK evaluation. Third, we did not include a control group of patients treated with other antifibrinolytics (e.g., tranexamic acid); however, efficacy was not selected as the primary end point in this phase II study.…”

Section: Discussionmentioning

confidence: 99%

A Novel Blood-Sparing Agent in Cardiac Surgery? First In-Patient Experience with the Synthetic Serine Protease Inhibitor MDCO-2010

Englberger

Dietrich

Eberle

et al. 2014

Anesthesia &Amp; Analgesia

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This first-in-patient study demonstrated dosage-proportional PK for MDCO-2010 and reduction of chest tube drainage and transfusions in patients undergoing primary coronary artery bypass grafting. Antifibrinolytic and anticoagulant effects were demonstrated using various markers of coagulation. MDCO-2010 was well tolerated and showed an acceptable initial safety profile. Larger multi-institutional studies are warranted to further investigate the safety and efficacy of this compound.

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Section: Discussionmentioning

confidence: 99%

A Novel Blood-Sparing Agent in Cardiac Surgery? First In-Patient Experience with the Synthetic Serine Protease Inhibitor MDCO-2010

Englberger

Dietrich

Eberle

et al. 2014

Anesthesia &Amp; Analgesia

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“…Tranexamic acid (TXA) is a synthetic analogue of the amino acid lysine and can block lysinebinding sites on plasminogen, thus preventing its conversion to plasmin and executing antifibrinolytic function ( 2 ). The effect of TXA to reduce perioperative blood loss and blood transfusion has been well established in many trials and its usage in cardiac surgeries has been recommended in the guideline ( 3 ), but the optimal dosage of TXA in cardiac surgery has always been a problem of debate.…”

Section: Introductionmentioning

confidence: 99%

High-Dose Tranexamic Acid in Patients Underwent Surgical Repair of Aortic Dissection Might Reduce Postoperative Blood Loss: A Cohort Analysis

et al. 2022

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IntroductionWhile tranexamic acid (TXA) is widely used in patients with acute type A aortic dissection (ATAAD) who undergo surgical repair to reduce blood loss and transfusion requirement, the optimal dosage of TXA is unknown in these patients.Materials and MethodsThis was a retrospective cohort study that compared high-dose (>50 mg/kg) and low-dose TXA (≤50 mg/kg) in patients with ATAAD who underwent surgical repair. Propensity score matching (PSM) was performed between the two groups and results were analyzed in matched cases. The primary outcome was postoperative blood loss within 3 days after surgery. The secondary outcomes were total blood loss after surgery and perioperative blood transfusion, and safety outcomes were also assessed.ResultsThrough medical record screening, 529 patients were identified. After PSM, 196 patients in the high-dose group and 196 patients in the low-dose group were matched and included in the final analysis. Postoperative blood loss in 3 days after surgery was 940 mL (710–1,010 mL) in the low-dose group and 695 mL (620–860 mL) in the high-dose group. The difference was statistically significant (P < 0.001). Total postoperative blood loss was also statistically less in the high-dose group compared to the low-dose group (1,890 mL (1,410–2,100 mL) vs. 2,040 mL (1,460–2,320 mL), P = 0.032). No difference was found between the two groups in transfusion and safety outcomes.ConclusionIn ATAAD patients who underwent surgical repair, high-dose TXA significantly reduced postoperative blood loss compared to low-dose TXA, while no difference in transfusion or adverse events was found.

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