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Risk of death may be higher with drug commonly used during cardiac surgery
December 03, 2008Health Canada committee meeting Dec. 3 to determine use of blood loss drug
The risks of death are probably higher with aprotinin, a drug commonly used to control blood loss and transfusions during cardiac surgery, compared with lysine analogues, according to a study http://www.cmaj.ca//cgi/rapidpdf/cmaj.081109 to be published in the January 20th issue of CMAJ.
On December 3, a Health Canada expert advisory panel will meet to decide on aprotinin use. The study is being early released in advance of the meeting.
The study, a systematic review of 49 randomized trials, compared aprotinin with lysine analogues. It includes new information from The Blood Conservation Using Antifibrinolytics in a Randomized Trial (BART) study published in May which was stopped prematurely because of a significant number of deaths in patients taking aprotinin.
In the CMAJ review, while aprotinin was slightly more effective at controlling blood loss and transfusions, its higher risk of death and significantly more expensive price were deterrents for its use. The authors recommend tranexamic acid or aminocaproic as alternatives to prevent blood loss during surgery.
"Lysine analogues are almost as effective as aprotinin in controlling blood loss, are cheaper, and appear not to increase mortality," conclude Dr. David Henry and coauthors.
Canadian Medical Association Journal
The study, a systematic review of 49 randomized trials, compared aprotinin with lysine analogues. It includes new information from The Blood Conservation Using Antifibrinolytics in a Randomized Trial (BART) study published in May which was stopped prematurely because of a significant number of deaths in patients taking aprotinin.
In the CMAJ review, while aprotinin was slightly more effective at controlling blood loss and transfusions, its higher risk of death and significantly more expensive price were deterrents for its use. The authors recommend tranexamic acid or aminocaproic as alternatives to prevent blood loss during surgery.
"Lysine analogues are almost as effective as aprotinin in controlling blood loss, are cheaper, and appear not to increase mortality," conclude Dr. David Henry and coauthors.
Canadian Medical Association Journal
Cardiac Surgery Current Events and Cardiac Surgery News RSSExperts unveil new CVD guidelines and position papers
Several new guidelines and position papers offering the most up to date information to ensure that clinicians practice evidence-based medicine were released at the Canadian Cardiovascular Congress 2009 this week.
MedImmune to present data on RSV and influenza at 2009 AAP National Conference and Exhibition
MedImmune announced today it will present four abstracts at the American Academy of Pediatrics (AAP) 2009 National Conference & Exhibition that add to the company's growing body of research on the burden of respiratory syncytial virus (RSV) on children, as well as pediatric infectious disease prevention.
Study details safe, effective, minimally invasive mitral valve repair
Surgical treatment for mitral valve disease includes either repairing the patient's diseased valve or replacing it with a metal, mechanical valve or an animal tissue valve.
Is there long-term brain damage after bypass surgery? More evidence puts the blame on heart disease
Brain scientists and cardiac surgeons at Johns Hopkins have evidence from 227 heart bypass surgery patients that long-term memory losses and cognitive problems they experience are due to the underlying coronary artery disease itself and not ill after-effects from having used a heart-lung machine.
Is RTA a new potential option for the treatment of hydatid cysts?
Current treatment of cystic echinococcosis is surgery or percutaneous aspiration, injection and reaspiration (PAIR) using hypertonic saline or ethanol.
Mayo Study Finds That Team Preop Briefing Improves Communication, Reduces Errors
A short, preoperative team briefing prior to cardiac surgery - where each person on the team speaks - improves communication and reduces errors and costs, according to a pilot study conducted at Mayo Clinic.
Different treatment options in chronic coronary artery disease
Sometimes cardiologists and cardiac surgeons can agree! There is often disagreement between the professions of cardiology and cardiac surgery about the proper therapy for coronary artery disease (CAD)-and this can harm the patient.
Omega-3 Fatty Acids May Benefit Cancer Patients Undergoing Major Operations
New research from Trinity College Dublin published in this month's Annals of Surgery points to a potentially significant advance in the treatment of patients undergoing major cancer surgery.
Study reveals worrying survival gap between rich and poor after heart surgery
People from the most deprived areas of England have a far higher risk of death after cardiac surgery than people from the least deprived areas, finds a large study published on bmj.com today.
Journal of American College of Surgeons finds lung transplantation should be used in older patients
New research published in the March issue of the Journal of the American College of Surgeons suggests that lung transplantation should be used with caution in patients older than 60 years and that the procedure is associated with high rates of mortality after one year in patients 70 and older.
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