1 found that the risk of death was not significantly higher with tranexamic acid than with placebo among patients undergoing cardiac surgery. This drug has a class IA indication for bleeding prophylaxis, decreasing the use of blood products and the risk of reintervention. Doses that are less than 50 mg per kilogram of body weight are effective in preventing bleeding as well as in decreasing the inflammatory response that is associated with cardiopulmonary bypass.
2Patients with the 5G/G genotype had a greater blood-sparing benefit with the use of tranexamic acid than those with the 4G genotype of the plasminogen-activator inhibitor type 1 polymorphism.3 It will be important for future studies to take into account the pharmacogenomics of tranexamic acid in order to adjust dosing appropriately and to decrease the risk of dose-related adverse effects.
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