Key result
Tranexamic acid significantly mitigated the reduction of collagen-induced whole blood platelet aggregation following cardiopulmonary bypass compared with control (36% vs 58% reduction; p=0.011).
Why the study?
Does tranexamic acid improve collagen-induced whole blood platelet aggregation in patients undergoing primary cardiac valve surgery?
Does tranexamic acid improve collagen-induced whole blood platelet aggregation in patients undergoing primary cardiac valve surgery?
Absolute Event Rate: 36% vs 58%
p-value: p=0.011
Tranexamic acid significantly preserves collagen-induced whole blood platelet aggregation and reduces fibrinolysis following cardiopulmonary bypass in primary cardiac valve surgery.
Tranexamic acid was associated with preserved platelet aggregation post-bypass in valve surgery; challenges consensus on antifibrinolytics but remains hypothesis-generating.
Haemostatic disorder is one of the most common complications following cardiac surgery with cardiopulmonary bypass (CPB). Tranexamic acid reduces blood loss and allogeneic blood transfusion requirement in cardiac surgery. It had been thought that tranexamic acid inhibited fibrinolysis alone following CPB. In the present study, the haemostatic effects of tranexamic acid (20 mg/kg body weight bolus after induction of anaesthesia followed by continuous infusion at 2 mg/kg/h), including fibrinolysis and platelet function, were investigated in 22 patients (tranexamic acid group n = 12; control group n = 10) undergoing primary cardiac valve surgery. Fibrinolysis following CPB was reduced significantly in the tranexamic acid group. Following protamine administration, the reduction of collagen-induced whole blood platelet aggregation was mitigated significantly in the tranexamic acid group compared with the control group (36% reduction in the tranexamic acid group vs 58% in the control group; p = 0.011), although platelet counts did not differ between the two groups. In conclusion, tranexamic acid not only inhibits fibrinolysis directly, but also may preserve platelet function following CPB.
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Miyashita et al. (2000) studied Primary cardiac valve surgery (n=22). Tranexamic acid vs. Control group was evaluated on Reduction of collagen-induced whole blood platelet aggregation following protamine administration (p=0.011). Tranexamic acid significantly mitigated the reduction of collagen-induced whole blood platelet aggregation following cardiopulmonary bypass compared with control (36% vs 58% reduction; p=0.011).
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