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Effect of tranexamic acid on transfusion requirement in dual antiplatelet-treated anemic patients undergoing off-pump coronary artery bypass graft surgery.

 So Woon Ahn  ;  Jae Kwang Shim  ;  Young Nam Youn  ;  Jong Wook Song  ;  So Young Yang  ;  Sung Chan Chung  ;  Young Lan Kwak 
 CIRCULATION JOURNAL, Vol.76(1) : 96-101, 2012 
Journal Title
Issue Date
Aged ; Anemia/complications* ; Anemia/epidemiology ; Antifibrinolytic Agents/therapeutic use ; Blood Loss, Surgical/prevention & control* ; Blood Transfusion* ; Comorbidity ; Coronary Artery Bypass, Off-Pump* ; Coronary Disease/epidemiology ; Coronary Disease/surgery* ; Double-Blind Method ; Female ; Humans ; Male ; Platelet Aggregation Inhibitors/therapeutic use* ; Time Factors ; Tranexamic Acid/therapeutic use* ; Treatment Outcome
Anemia ; Dual antiplatelet therapy ; Off-pump coronary artery bypass ; Tranexamic acid
BACKGROUND: Anemia is not rare in patients presenting for coronary artery bypass graft surgery (CABG) and as these patients are frequently on dual antiplatelet therapy (DAPT), the coexisting conditions could potentially increase the risk of bleeding and transfusion. The aim of this study was to evaluate the effect of tranexamic acid (TA) on blood loss and transfusion in preoperatively anemic patients who continued DAPT until within 5 days of off-pump CABG (OPCAB). METHODS AND RESULTS: Seventy-six anemic patients were randomized into 2 groups: TA group receiving TA (1g bolus followed by infusion at 200mg/h) and a Control group receiving the same volume of saline. The amount of blood loss and transfusion requirement during, and at 4 and 24h after the operation were assessed. Patients' characteristics and operative data were similar between the groups. During the perioperative period, which combined the intraoperative and postoperative 24h data, the TA group received significantly smaller amounts of packed red blood cells and fresh frozen plasma. Total amount of perioperative blood loss was similar between the groups, although the blood loss during the postoperative 4h was significantly less in the TA group. CONCLUSIONS: TA infusion could reduce the amount of transfusion during the perioperative period in patients with preoperative anemia who continue DAPT until within 5 days of OPCAB.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Yang, So Young(양소영)
Youn, Young Nam(윤영남)
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