Low postoperative dose of aprotinin reduces bleeding and is safe in patients receiving clopidogrel before coronary artery bypass surgery. A prospective randomized study.

2.50
Hdl Handle:
http://hdl.handle.net/10143/110896
Title:
Low postoperative dose of aprotinin reduces bleeding and is safe in patients receiving clopidogrel before coronary artery bypass surgery. A prospective randomized study.
Authors:
Øvrum, Eivind; Tangen, Geir; Tølløfsrud, Stein; Ringdal, Mari-Anne L; Øystese, Rolf; Istad, Reidar
Citation:
Interactive cardiovascular and thoracic surgery. 2010, 10 (4):545-8
Additional Links:
http://icvts.ctsnetjournals.org/

Full metadata record

DC FieldValue Language
dc.contributor.authorØvrum, Eivinden
dc.contributor.authorTangen, Geiren
dc.contributor.authorTølløfsrud, Steinen
dc.contributor.authorRingdal, Mari-Anne Len
dc.contributor.authorØystese, Rolfen
dc.contributor.authorIstad, Reidaren
dc.date.accessioned2010-09-09T09:13:56Z-
dc.date.available2010-09-09T09:13:56Z-
dc.date.issued2010-04-
dc.identifier.citationInteractive cardiovascular and thoracic surgery. 2010, 10 (4):545-8en
dc.identifier.issn1569-9285-
dc.identifier.pmid20067988-
dc.identifier.doi10.1510/icvts.2009.226613-
dc.identifier.urihttp://hdl.handle.net/10143/110896-
dc.description.abstractClopidogrel (Plavix) given before the operation increases bleeding complications following coronary artery bypass grafting (CABG). High perioperative doses of aprotinin (Trasylol) are known to reduce bleeding and transfusions after cardiac surgery, but may increase the risk of thrombosis, renal impairment, and mortality. The aim of the study was to evaluate the clinical effects of aprotinin given in high doses intra- and postoperatively vs. a low postoperative dose in patients on clopidogrel. Patients admitted for first-time CABG and receiving clopidogrel with or without aspirin, were prospectively randomized either to receive a total of 75,000 kallikrein inhibitor unit (KIU)/kg aprotinin given intra- and postoperatively or 25,000 KIU/kg aprotinin after the operation. Three hundred and ninety-nine patients aged 32-87 years (median 67 years) were included. Postoperative bleeding was slightly different, but moderate in both groups. The transfusion rate was similar, as were the incidences of postoperative neurological disturbances and myocardial infarction. Renal impairment and need for inotropic drugs were more frequent in the high dose group. Thirty-day mortality was similar (high dose 2%, low dose 0.5%, P=0.22). A low postoperative dose of aprotinin in patients receiving clopidogrel is safe and has comparable effects regarding postoperative bleeding complications as a high dose.en
dc.language.isoenen
dc.relation.urlhttp://icvts.ctsnetjournals.org/en
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771en
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAprotininen
dc.subject.meshBlood Transfusionen
dc.subject.meshCerebrovascular Disordersen
dc.subject.meshCoronary Artery Bypassen
dc.subject.meshDrug Administration Scheduleen
dc.subject.meshFemaleen
dc.subject.meshHemostaticsen
dc.subject.meshHumansen
dc.subject.meshIntraoperative Careen
dc.subject.meshKidney Diseasesen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMyocardial Infarctionen
dc.subject.meshPlatelet Aggregation Inhibitorsen
dc.subject.meshPostoperative Careen
dc.subject.meshPostoperative Hemorrhageen
dc.subject.meshProspective Studiesen
dc.subject.meshTiclopidineen
dc.subject.meshTime Factorsen
dc.subject.meshTreatment Outcomeen
dc.titleLow postoperative dose of aprotinin reduces bleeding and is safe in patients receiving clopidogrel before coronary artery bypass surgery. A prospective randomized study.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.contributor.departmentDivision of Cardiovascular and Respiratory Medicine and Surgery, Oslo Heart Center, Oslo University Hospital, Rikshospitalet, Norway. eivind.ovrum@hjertesenteret.noen
dc.identifier.journalInteractive cardiovascular and thoracic surgeryen
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