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THE JOURNAL OF CARDIOVASCULAR SURGERY
A Journal on Cardiac, Vascular and Thoracic Surgery
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2003 April;44(2):205-8
Tranexamic acid reduces bleeding after off-pump coronary artery bypass grafting
Jares M., Vanek T., Straka Z., Brucek P.
Department of Cardiac Surgery 3rd Medical School of Charles University Kralovske Vinohrady University Hospital Prague, Czech Republic
Aim. To assess the ability of tranexamic acid, compared with an untreated control group, to decrease bleeding and transfusion requirements in patients undergoing coronary artery bypass grafting on the beating heart.
Methods. Forty-nine randomly selected patients were enrolled to elective coronary artery bypass grafting without the use of cardiopulmonary bypass. Of these, 23 received tranexamic acid (bolus of 1 g before surgical incision, followed by infusion 200 mg/hour during surgery) and 26 patients were enrolled into a control group. Preoperative hematological variables, postoperative blood loss at 4 and 24 hours, transfusion requirements of packed red blood cells,and postoperative thrombotic events such as a myocardial infarction, stroke and pulmonary embolism were recorded.
Results. The two groups were similar in terms of patients’ characteristics. Postoperative bleeding was significantly lower in the tranexamic acid group compared with the control group (median [25th-75th percentiles]): 115 [92-148] vs 230 [170-260] mL at 4 hours, p<0.001; 420 [330-523] vs 550 [500-650] mL at 24 hours, p<0.01). Transfusion requirements were lower in the tranexamic acid group compared with the control group (RBC 9% vs 28%), but the difference was not statistically significant. Treatment with tranexamic acid was not associated with a higher incidence of myocardial ischemia or other thrombotic events.
Conclusion. Tranexamic acid reduces postoperative blood loss after coronary artery bypass grafting on the beating heart. Evaluation of transfusion requirements warrants further study.