The effect of tranexamic acid on myocardial injury in cardiac surgical patients: a systematic review and meta-analysis

Abstract

Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic agents for surgical patients. However, the effect of TXA on myocardial injury remains controversial. We systemically reviewed literature regarding the effectiveness of TXA on myocardial injury in patients who have undergone a cardiac surgery. We included all randomized controlled trials (RCTs) comparing TXA and control (saline) in cardiac surgical patients. Relevant studies were identified by a comprehensive electronic literature search from database inception to 15 August 2021. A standardized data extraction form was used to collect methodological and outcome variables from each eligible study. We conducted a meta-analysis to estimate the pooled effect size of TXA administration on myocardial injury. In total, eight RCTs were identified, with 292 patients in the TXA group, and 241 patients in saline or control group. The meta-analysis demonstrated that patients in the TXA group had lower levels of CK-MB and cTnI within 24 h postoperatively (CK-MB: P = 0.005; cTnI: P = 0.01), compared with the saline group. No significant difference was found with respect to AST level (P = 0.71) between TXA and saline groups within 24 h postoperatively. TXA administration was found to be associated with less myocardial injury among patients who have undergone cardiac surgery. High-quality randomized controlled trials are warranted to further examine the cardioprotective effects of TXA.

Elektif Koroner Arter Bypass Cerrahisinde Traneksamik Asit Uygulama Tekniğinin Etkinliği

“…Pediatrik hasta grubunda koroner arter hastalığı olmadığı için bu grupta yapılan çalışmalarda TXAnın myokard hasarı ile bir ilişkisi saptanmamıştır. 14,16,17 Bizim çalışmamızda nöbet geçiren hasta olmadı. TXAnın epileptik nöbete neden olma mekanizması tam olarak açıklanamamıştır.…”

Pharmacological Cardioprotection against Ischemia Reperfusion Injury—The Search for a Clinical Effective Therapy

“…Nowadays, the most commonly used antifibrinolytic is tranexamic acid. In a recent review and meta-analysis, the authors concluded tranexamic acid administration was associated with less myocardial injury in cardiac surgery patients [256]. These results suggest that direct thrombin inhibitors might be novel pharmacological agents to protect the heart.…”