Original articleAdult cardiacEffects of Aprotinin on Short-Term and Long-Term Outcomes After Coronary Artery Bypass Grafting Surgery
Section snippets
Study Design
This was a retrospective, observational study of consecutive patients who underwent isolated primary CABG at the Fuwai Hospital. The study protocol was approved by the the Ethics Committee of Fuwai Hospital, and a waiver of the requirement of written informed consent was obtained.
Study Population
From January 1999 to December 2005, data of 5,559 consecutive patients undergoing CABG at Fuwai hospital, Beijing, China were prospectively entered into a surgical database. Data were extracted for 5,103 patients who
Baseline Characteristics
The comparison of baseline characteristics between the aprotinin group and control group showed some significant differences. But there were no significant differences between the two groups after propensity adjustment (Table 1).
Perioperative Outcomes
Blood loss after operation was significantly reduced in the aprotinin group as compared with that in the control group (462.4 ± 251.7 vs 739.5 ± 342.4, p < 0.001). Application of aprotinin was not associated with the perioperative mortality (1.2% vs 1.0%, p = 0.57) or
Comment
In the present study, Chinese patients, as the sample from the Asian population, were investigated to show whether the adverse effect mentioned by the above studies would happen after receiving aprotinin during isolated primary CABG. In our findings, aprotinin could significantly reduce blood loss but was not associated with the risk of short-term or long-term mortality and complications, including renal, cerebrovascular, and cardiovascular adverse events.
The mechanisms of aprotinin have been
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2020, American Heart JournalCitation Excerpt :We believe this design will help us to identify the true incidence of TxA-related seizures and will provide additional information for determining the optimal dose of TxA for cardiac surgery. After the classic antifibrinolytic agent aprotinin was withdrawn from the market, selecting effective antifibrinolytic agents with an optimal regimen for patients undergoing cardiac surgery with CPB has been challenging, especially in Chinese patients who have relatively poor coagulation function as compared with Western patients.32,33 In China, the number of cardiac surgeries with CPB has increased, recently reaching more than 150,000 cases per year.34
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2013, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :These findings are in line with previous reports, encompassing 17 randomized controlled trials of approximately 5000 patients that compared treatment with the full-Hammersmith dose of aprotinin with tranexamic acid.1,6-21 Of these studies, 5 indicated aprotinin as the most effective in terms of reduction of blood loss and transfusion requirements,6,10,14,18,22 whereas none identified tranexamic acid as such. Wang and colleagues22 investigated patients who underwent isolated CABG and concluded that, compared with the 981 control patients who received no aprotinin, the 4122 patients treated with the full-Hammersmith aprotinin regimen demonstrated significantly reduced blood loss.
Aprotinin revisited
2012, Journal of Thoracic and Cardiovascular Surgery
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The first two authors contributed equally to this paper.