&lt;b&gt;Acute Myocardial Infarction After Tranexamic Acid: Review of Published
Case Reports&lt;/b&gt;

Yao, Yun Tai; Yuan, Xin; Shao, Ken

doi:10.24920/003596

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…[ 21 , 31 ] Preliminary evidence has suggested a possible association of TXA administration and an increased risk of acute myocardial infarction, even in patients with relatively low thrombotic risk. [ 52 ] The retrospective analysis from Fuwai Hospital also demonstrated that TXA administration led to increased risk of perioperative myocardial infarction by1.4-fold. [ 33 ] Intriguingly, the effect of TXA on myocardial biomarkers (e.g., cTn, creatine kinase-MB) in cardiac surgical patients remains controversial.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of intravenous administration of tranexamic acid in patients undergoing cardiac surgery: Evidence from a single cardiovascular center

Lin¹,

Yao²,

Tian³

et al. 2023

Medicine

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Background: The current study was performed to systemically review the efficacy and safety of tranexamic acid (TXA) in patients undergoing cardiac surgery at a single large-volume cardiovascular center.Methods: A computerized search of electronic databases was performed to identify all relevant studies using search terms till December 31 st , 2021. The primary outcomes were postoperative blood loss and the composite incidence of mortality and morbidities during hospitalization. Secondary outcomes included postoperative massive bleeding and transfusion, postoperative recovery profiles, coagulation functions, inflammatory variables, and biomarkers of vital organ injury.Results: Database search yielded 23 qualified studies including 27,729 patients in total. Among them, 14,136 were allocated into TXA group and 13,593 into Control group. The current study indicated that intravenous TXA significantly reduced total volume of postoperative bleeding in both adult and pediatric patients, and that medium-and high-dose TXA were more effective than low-dose TXA in adult patients (P < .05). The current study also demonstrated that intravenous TXA, as compared to Control, remarkably reduced postoperative transfusion incidences and volume of red blood cell and fresh frozen plasma, and reduced postoperative transfusion incidence of platelet concentrates (PC) (P < .05) without obvious dose-effects (P > .05), but TXA did not reduce PC transfusion volume postoperatively in adult patients (P > .05). For pediatrics, TXA did not significantly reduce postoperative transfusion incidence and volume of allogenic red blood cell, fresh frozen plasma and PC (P > .05). Additionally, the current study demonstrated that intravenous TXA did not influence the composite incidence of postoperative mortality and morbidities in either adults or pediatrics during hospitalization (P > .05), and that there was no obvious dose-effect of TXA in adult patients (P > .05).Conclusions: This current study suggested that intravenous TXA significantly reduced total volume of postoperative bleeding in both adult and pediatric patients undergoing cardiac surgery at the single cardiovascular center without increasing the composite incidence of mortality and morbidities.Abbreviations: CABG = coronary artery bypass graft, CPB = cardiopulmonary bypass, cTn = cardiac troponin, DAPT = dual antiplatelet therapy, FFP = fresh frozen plasma, IL = Interleukin, INR = international normalized ratio, LOS = length of stay, PC = Platelet concentrates, Plt = platelet, PMNE = polymorphonuclear neutrophil elastase, PT = prothrombin time, RBC = red blood cell, RCT = randomized controlled trial, SAPT = single antiplatelet therapy, TXA = tranexamic acid, WBC = white blood cell.

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Section: Discussionmentioning

confidence: 99%

The efficacy and safety of intravenous administration of tranexamic acid in patients undergoing cardiac surgery: Evidence from a single cardiovascular center

Lin¹,

Yao²,

Tian³

et al. 2023

Medicine

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“…It can also prevent plasmin-led degradation of platelet receptors, thus preserving platelet function 11 . There is limited high-level clinical guidance as to the effects of administering TXA in patients with acute MI, given the experiences that led to the clinical withdrawal of aprotinin 1,12,13 .…”

Section: Discussionmentioning

confidence: 99%

Tranexamic Acid Use During Surgery Associated with Extension of Acute Perioperative Type 1 Myocardial Infarction

Lynham

Preissler

Lightfoot

et al. 2022

JBJS Case Connector

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Case Presentation: A 70-year-old women presented to a regional hospital after a fall, resulting in a periprosthetic femoral fracture. Preoperative echocardiogram was ordered to investigate a cardiac murmur, and unexpectedly, a significant regional wall abnormality was found. Further repeat electrocardiograph and troponin blood biomarker analysis demonstrated the patient had suffered an acute type 1 myocardial infarction after admission to the ward, without exhibiting classical ischemic cardiac symptoms. A multidisciplinary decision was made for the patient to proceed to surgery, and at that time, she received tranexamic acid (TXA). Postoperatively, there was notable echocardiographic extension of the infarction, which required transfer to a tertiary center for management with complex coronary artery stenting. The patient once discharged was followed up by cardiology at the 3-month interval. Conclusion: The use of TXA in arterial thromboembolic disease requires thorough consideration because it may contribute to further myocardial damage. A patient-specific approach should be adopted with the risk of thrombosis extension being considered.

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“…The administration of TXA was found in our meta-analysis to be a protective factor against myocardial infarction in trauma patients. While the use of TXA in non-trauma patients was described in seven cases to correlate with myocardial infarction [43], the vast majority of "elective" TXA use describe it as a protective factor [44,45]. Additionally, the use of TXA was associated with a lower rate of central nervous failure [24], possibly via reducing the cytotoxicity in the TLR4/TNF axis [46].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Emergency Trauma: A Systematic Review and Meta-Analysis

Al-Jeabory¹,

Szarpak

Attila³

et al. 2021

JCM

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In trauma patients, bleeding can lead to coagulopathy, hemorrhagic shock, and multiorgan failure, and therefore is of fundamental significance in regard to early morbidity. We conducted a meta-analysis to evaluate the efficacy and safety of tranexamic acid (TXA) in civil and military settings and its impact on in-hospital mortality (survival to hospital discharge or 30-day survival), intensive care unit and hospital length of stay, incidence of adverse events (myocardial infarct and neurological complications), and volume of blood product transfusion. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic review of the literature using PubMed, Scopus, EMBASE, Web of Science, and the Cochrane Central Register and Controlled Trials (CENTRAL) database was conducted from inception to 10 January 2021. In-hospital mortality was reported in 14 studies and was 15.5% for the TXA group as compared with 16.4% for the non-TXA group (OR = 0.81, 95% CI 0.62–1.06, I2 = 83%, p = 0.12). In a civilian TXA application, in-hospital mortality in the TXA and non-TXA groups amounted to 15.0% and 17.1%, respectively (OR = 0.69, 95% CI 0.51–0.93, p = 0.02, I2 = 78%). A subgroup analysis of the randomized control trial (RCT) studies showed a statistically significant reduction in in-hospital mortality in the TXA group (14.3%) as compared with the non-TXA group (15.7%, OR = 0.89, 95% CI 0.83–0.96, p = 0.003, I2 = 0%). To summarize, TXA used in civilian application reduces in-hospital mortality. Application of TXA is beneficial for severely injured patients who undergoing shock and require massive blood transfusions. Patients who undergo treatment with TXA should be monitored for clinical signs of thromboembolism, since TXA is a standalone risk factor of a thromboembolic event and the D-dimers in traumatic patients are almost always elevated.

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<b>Acute Myocardial Infarction After Tranexamic Acid: Review of Published Case Reports</b>

Cited by 3 publications

References 22 publications

The efficacy and safety of intravenous administration of tranexamic acid in patients undergoing cardiac surgery: Evidence from a single cardiovascular center

The efficacy and safety of intravenous administration of tranexamic acid in patients undergoing cardiac surgery: Evidence from a single cardiovascular center

Tranexamic Acid Use During Surgery Associated with Extension of Acute Perioperative Type 1 Myocardial Infarction

Efficacy and Safety of Tranexamic Acid in Emergency Trauma: A Systematic Review and Meta-Analysis

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