Antifibrinolytic drugs reduce blood loss during cardiac surgery

October 16, 2007

The amount of blood loss that occurs during major complex surgery is limited by the body's ability to form blood clots. These close off small vessels and prevent more blood leaking out of the patient's circulatory system. One problem is that the body also has mechanisms that break down blood clots.

This Cochrane Review concludes that drugs that slow down the rate at which these blood clots are dissolved, called anti-fibrinolytics, can significantly reduce blood loss, particularly during cardiac surgery, and reduce the need for re-operation because of continued bleeding. One of the effective drugs, tranexamic acid, is quite cheap and is likely to be cost effective, particularly in cardiac surgery.

The big question is whether the benefits of treatment with these drugs are offset by adverse effects, in particular thrombosis leading to an excess risk of heart attack and stroke. This has been a particular concern with aprotinin and some studies that did not use randomisation found an increased risk of these complications with this drug. However, this Cochrane Review of randomised controlled trials found no increase in the risk of thrombosis with aprotinin or tranexamic acid.

"Our review of over 200 clinical trials found that using anti-fibrinolytic drugs during surgery reduced bleeding and reduced the need for transfusions of red blood cells. Importantly they did not appear to increase the risk of serious adverse effects," says lead researcher Professor David Henry, of the University of Newcastle, Waratah, Australia.

"This is an extremely important finding," says Professor Mike Clarke, the UK Cochrane Centre Director. "It shows very strongly that anti-fibrinolytics, which are cheap, can dramatically reduce the need for blood transfusion. Blood is scarce, expensive and transfusions can be dangerous, so this is likely to be a very important finding globally."
-end-


Wiley

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.