February 20, 2008New England Journal of Medicine
Aprotinin during Coronary-Artery Bypass Grafting and Risk of Death
Key result
Aprotinin use during coronary-artery bypass grafting was associated with a higher risk of death compared to aminocaproic acid (4.5% vs 2.5%; adjusted RR 1.64, 95% CI 1.50-1.78).
Why the study?
Does aprotinin increase the risk of death compared to aminocaproic acid in patients undergoing coronary-artery bypass grafting?
Population
78,199 hospitalized patients undergoing coronary-artery bypass grafting
Comparison
Aprotinin administered on the day CABG was… vs Aminocaproic acid administered on the day CABG…
Design
Cohort
Follow-up
In-hospital
Authors
Discussion
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Implication
Should not yet change aprotinin use in CABG; leaves open whether randomized trials confirm higher mortality versus aminocaproic acid.
Study Design
Type
Cohort (n=78,199)
Multicenter
Yes
Structured PICO
Does aprotinin increase the risk of death compared to aminocaproic acid in patients undergoing coronary-artery bypass grafting?
P
Population
78,199 hospitalized patients undergoing coronary-artery bypass grafting who received either aprotinin or aminocaproic acid.
E
Exposure
Aprotinin administered on the day CABG was performed
C
Comparator
Aminocaproic acid administered on the day CABG was performed
O
Outcome
In-hospital death (hospital-discharge status of death)hard clinical
Main Result
Relative Risk: 1.64 (95% CI 1.5–1.78)
Absolute Event Rate: 4.5% vs 2.5%
In patients undergoing CABG, the use of aprotinin is associated with a significantly higher risk of in-hospital mortality, postoperative revascularization, and dialysis compared to aminocaproic acid.
Cite This Study
Schneeweiß et al. (2008) conducted a cohort in Coronary-artery bypass grafting (n=78,199). Aprotinin vs. Aminocaproic acid was evaluated on Hospital-discharge status of death (RR 1.64, 95% CI 1.50-1.78). Aprotinin use during coronary-artery bypass grafting was associated with a higher risk of death compared to aminocaproic acid (4.5% vs 2.5%; adjusted RR 1.64, 95% CI 1.50-1.78).