Outcomes of Tranexamic Acid Use Assessed in Coronary Surgery Patients

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Lower bleeding risk in patients undergoing coronary artery surgery at risk of peri-op complications
Lower bleeding risk in patients undergoing coronary artery surgery at risk of peri-op complications

HealthDay News — Tranexamic acid is associated with a lower risk of bleeding than placebo for patients undergoing coronary artery surgery without increased risk of death or thrombotic complications, according to a study published online October 23 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Society of Anesthesiologists, held from October 22 to 26 in Chicago.

Paul S. Myles, MPH, MD, from Alfred Hospital in Melbourne, Australia, and colleagues conducted a trial in which patients who were scheduled to undergo coronary artery surgery and were at risk for perioperative complications were randomized to receive aspirin or placebo and tranexamic acid or placebo. Of the 4,631 patients who underwent surgery and had available outcomes data, 2,311 were assigned to tranexamic acid and 2,320 to placebo.

The researchers found that 16.7 and 18.1% of the tranexamic acid and placebo groups, respectively, had a primary outcome event (composite of death and thrombotic complications) (relative risk, 0.92; 95% confidence interval, 0.81 to 1.05). The total number of units of blood products transfused during hospitalization was 4,331 and 7,994 in the tranexamic acid and placebo groups, respectively (P<0.001).

"Among patients undergoing coronary-artery surgery, tranexamic acid was associated with a lower risk of bleeding than was placebo, without a higher risk of death or thrombotic complications within 30 days after surgery," the authors write.

Bayer Pharma provided the aspirin and matched placebo tablets used in the aspirin comparison.

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