Tags

Type your tag names separated by a space and hit enter

Aprotinin decreases postoperative bleeding and number of transfusions in patients on clopidogrel undergoing coronary artery bypass graft surgery: a double-blind, placebo-controlled, randomized clinical trial.
Circulation. 2005 Aug 30; 112(9 Suppl):I276-80.Circ

Abstract

BACKGROUND

Clopidogrel, an irreversible platelet inhibitor, is used to treat patients with unstable angina. These patients often present for coronary artery bypass graft surgery (CABG) and are at increased risk for perioperative bleeding. The current investigation evaluates the impact of aprotinin on bleeding and transfusion requirements in clopidogrel-treated patients undergoing CABG.

METHODS AND RESULTS

Seventy-five consecutive patients with unstable angina, administered clopidogrel <5 days before CABG, were randomized. Using a double-blind design, patients received full-dose aprotinin (n =37) or saline (n =38). Elapsed times between the last dose of clopidogrel and start of the operation were similar between the 2 groups [aprotinin, 58+/-28 hour (mean+/- SD); control, 54+/-27 hour; P=0.86], as were age (aprotinin, 66.4+/-10 years; control, 68.3+/-10 years; P=0.51), number of distal anastomoses (aprotinin, 3.6+/-1.0; control, 3.7+/-1.0; P=0.79), operative times (aprotinin, 192+/-48 minutes; control, 200+/-53 minutes; P=0.55), and lowest intraoperative hemoglobin level (aprotinin, 87+/-14 g/L; control, 88+/-14 g/L; P=0.60). Postoperative bleeding was 760+/-350 mL in aprotinin-treated patients versus 1200+/-570 mL (P<0.001) in control. During the hospital stay, patients in the aprotinin group received 1.2+/-1.5 and 0.1+/-0.4 U of erythrocytes and platelets, respectively, versus 2.8+/-3.2 (P=0.02) and 0.9+/-1.4 (P=0.002) units in the control. In the aprotinin group, 53% of patients received transfusions, whereas 79% of controls were exposed to blood products (P=0.02).

CONCLUSIONS

Intraoperative aprotinin decreases postoperative bleeding and the number of transfusions in patients undergoing CABG and treated with clopidogrel <5 days before surgery.

Authors+Show Affiliations

Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Karolinska Institute, SE-17176 Stockholm, Sweden. janvan@ki.seNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16159831

Citation

van der Linden, Jan, et al. "Aprotinin Decreases Postoperative Bleeding and Number of Transfusions in Patients On Clopidogrel Undergoing Coronary Artery Bypass Graft Surgery: a Double-blind, Placebo-controlled, Randomized Clinical Trial." Circulation, vol. 112, no. 9 Suppl, 2005, pp. I276-80.
van der Linden J, Lindvall G, Sartipy U. Aprotinin decreases postoperative bleeding and number of transfusions in patients on clopidogrel undergoing coronary artery bypass graft surgery: a double-blind, placebo-controlled, randomized clinical trial. Circulation. 2005;112(9 Suppl):I276-80.
van der Linden, J., Lindvall, G., & Sartipy, U. (2005). Aprotinin decreases postoperative bleeding and number of transfusions in patients on clopidogrel undergoing coronary artery bypass graft surgery: a double-blind, placebo-controlled, randomized clinical trial. Circulation, 112(9 Suppl), I276-80.
van der Linden J, Lindvall G, Sartipy U. Aprotinin Decreases Postoperative Bleeding and Number of Transfusions in Patients On Clopidogrel Undergoing Coronary Artery Bypass Graft Surgery: a Double-blind, Placebo-controlled, Randomized Clinical Trial. Circulation. 2005 Aug 30;112(9 Suppl):I276-80. PubMed PMID: 16159831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aprotinin decreases postoperative bleeding and number of transfusions in patients on clopidogrel undergoing coronary artery bypass graft surgery: a double-blind, placebo-controlled, randomized clinical trial. AU - van der Linden,Jan, AU - Lindvall,Gabriella, AU - Sartipy,Ulrik, PY - 2005/9/15/pubmed PY - 2006/2/24/medline PY - 2005/9/15/entrez SP - I276 EP - 80 JF - Circulation JO - Circulation VL - 112 IS - 9 Suppl N2 - BACKGROUND: Clopidogrel, an irreversible platelet inhibitor, is used to treat patients with unstable angina. These patients often present for coronary artery bypass graft surgery (CABG) and are at increased risk for perioperative bleeding. The current investigation evaluates the impact of aprotinin on bleeding and transfusion requirements in clopidogrel-treated patients undergoing CABG. METHODS AND RESULTS: Seventy-five consecutive patients with unstable angina, administered clopidogrel <5 days before CABG, were randomized. Using a double-blind design, patients received full-dose aprotinin (n =37) or saline (n =38). Elapsed times between the last dose of clopidogrel and start of the operation were similar between the 2 groups [aprotinin, 58+/-28 hour (mean+/- SD); control, 54+/-27 hour; P=0.86], as were age (aprotinin, 66.4+/-10 years; control, 68.3+/-10 years; P=0.51), number of distal anastomoses (aprotinin, 3.6+/-1.0; control, 3.7+/-1.0; P=0.79), operative times (aprotinin, 192+/-48 minutes; control, 200+/-53 minutes; P=0.55), and lowest intraoperative hemoglobin level (aprotinin, 87+/-14 g/L; control, 88+/-14 g/L; P=0.60). Postoperative bleeding was 760+/-350 mL in aprotinin-treated patients versus 1200+/-570 mL (P<0.001) in control. During the hospital stay, patients in the aprotinin group received 1.2+/-1.5 and 0.1+/-0.4 U of erythrocytes and platelets, respectively, versus 2.8+/-3.2 (P=0.02) and 0.9+/-1.4 (P=0.002) units in the control. In the aprotinin group, 53% of patients received transfusions, whereas 79% of controls were exposed to blood products (P=0.02). CONCLUSIONS: Intraoperative aprotinin decreases postoperative bleeding and the number of transfusions in patients undergoing CABG and treated with clopidogrel <5 days before surgery. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16159831/Aprotinin_decreases_postoperative_bleeding_and_number_of_transfusions_in_patients_on_clopidogrel_undergoing_coronary_artery_bypass_graft_surgery:_a_double_blind_placebo_controlled_randomized_clinical_trial_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.104.524611?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -