Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery

Ds, Wang; Mazer, C. David; Ba, Orser

doi:10.1056/nejmc1703369

Cited by 12 publications

(5 citation statements)

References 14 publications

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“…Cardiopulmonary bypass (CPB) initiated during cardiac surgery was demonstrated to activate clotting, exhaust coagulation factors, and cause platelet dysfunction and excessive fibrinolysis (3). Many clinical trials have demonstrated the effectiveness of TXA to maintain hemostasis in on-pump CABG (4,5).…”

Section: Introductionmentioning

confidence: 99%

Tranexamic Acid Administered During Off-Pump Coronary Artery Bypass Graft Surgeries Achieves Good Safety Effects and Hemostasis

Wang

Yuan

Wang³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundTranexamic acid (TXA) administered during off-pump coronary artery bypass (OPCAB) surgeries has achieved good blood control in small cohorts. We aimed to investigate the safety issues and hemostasis associated with TXA administration during OPCAB in a large retrospective cohort study.MethodsThis study included 19,687 patients with OPCAB from 2009 to 2019. A total of 1,307 patients were excluded because they were younger than 18 years or certain values were missing. Among the remaining 18,380 patients, 10,969 were in the TXA group and 7,411 patients were in the no-TXA group. There were 4,889 patients whose TXA dose was ≥50 mg/kg, and the remaining 6,080 patients had a TXA dose of <50 mg/kg. Propensity score matching (PSM) was performed between the TXA and no-TXA groups and between the high-dose and low-dose groups, and statistical analysis was performed.ResultsTranexamic acid administration did not increase the risk of hospital death or thromboembolic events. Patients who administered TXA had less blood loss at 24 h (478.32 ± 276.41 vs. 641.28 ± 295.09, p < 0.001) and 48 h (730.59 ± 358.55 vs. 915.24 ± 390.13, p < 0.001) and total blood loss (989.00 ± 680.43 vs. 1,220.01 ± 720.68, p < 0.001) after OPCAB than the patients with non-TXA. Therefore, the risk of total blood exposure [odds ratio (OR) = 0.50, 95% CI 0.47–0.54, p < 0.001] or blood component exposure (p < 0.001) was decreased significantly in the patients who administered TXA. The TXA dosage did not impact the patient survival, thromboembolic events, or blood management.ConclusionsThe application of TXA was safe and provided blood control in patients with OPCAB, and the dosage did not affect these parameters.

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Section: Introductionmentioning

confidence: 99%

Tranexamic Acid Administered During Off-Pump Coronary Artery Bypass Graft Surgeries Achieves Good Safety Effects and Hemostasis

Wang

Yuan

Wang³

et al. 2022

Front. Cardiovasc. Med.

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“…Several studies have demonstrated that TXA does not increase the risk of thromboembolic events. The following are a few examples: a study of orthopedic lower limb procedures, 17 the Aspirin and Tranexamic Acid for Coronary Artery Surgery trial, 18 and an excellent systematic review, meta-analysis, and meta-regression published by Taeuber et al 19 that included 216 trials investigating thromboembolic complications in intravenous (IV) TXA cohorts. Mild side effects of TXA include nausea and diarrhea; however, these effects were observed in 12% of patients in a trial on heavy menstrual bleeding with a dosage of 1 g 4 times daily for 4 days.…”

Section: Discussionmentioning

confidence: 99%

The Critical Blood-Sparing Effect of Tranexamic Acid (TXA) in Liposuction: A Systematic Review and Meta-Analysis

et al. 2024

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“…In some studies [ 81 , 82 , 83 , 84 , 85 ], individual heparin and protamine titration using an automated heparin titration device (Hepcon ® Hemostasis Management System, Medtronic, Minneapolis, MN, USA) was associated with decreased blood loss and transfusion requirements compared to a standard ACT management. However, bleeding and transfusion were secondary end points in these studies and larger multicenter studies are required [ 77 ].…”

Section: Challenges In the Intra-operative Phasementioning

confidence: 99%

Challenges in Patient Blood Management for Cardiac Surgery: A Narrative Review

Rancati

Scala

Ltaief

et al. 2021

JCM

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About 15 years ago, Patient Blood Management (PBM) emerged as a new paradigm in perioperative medicine and rapidly found support of all major medical societies and government bodies. Blood products are precious, scarce and expensive and their use is frequently associated with adverse short- and long-term outcomes. Recommendations and guidelines on the topic are published in an increasing rate. The concept aims at using an evidence-based approach to rationalize transfusion practices by optimizing the patient’s red blood cell mass in the pre-, intra- and postoperative periods. However, elegant as a concept, the implementation of a PBM program on an institutional level or even in a single surgical discipline like cardiac surgery, can be easier said than done. Many barriers, such as dogmatic ideas, logistics and lack of support from the medical and administrative departments need to be overcome and each center must find solutions to their specific problems. In this paper we present a narrative overview of the challenges and updated recommendations for the implementation of a PBM program in cardiac surgery.

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Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery

Cited by 12 publications

References 14 publications

Tranexamic Acid Administered During Off-Pump Coronary Artery Bypass Graft Surgeries Achieves Good Safety Effects and Hemostasis

Tranexamic Acid Administered During Off-Pump Coronary Artery Bypass Graft Surgeries Achieves Good Safety Effects and Hemostasis

The Critical Blood-Sparing Effect of Tranexamic Acid (TXA) in Liposuction: A Systematic Review and Meta-Analysis

Challenges in Patient Blood Management for Cardiac Surgery: A Narrative Review

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