PMID: 8957369Dec 1, 1996Paper

Aprotinin for primary coronary artery bypass grafting: a multicenter trial of three dose regimens

The Annals of Thoracic Surgery
J H LemmerR Maddi

Abstract

High-dose aprotinin reduces transfusion requirements in patients undergoing coronary artery bypass grafting, but the safety and effectiveness of smaller doses is unclear. Furthermore, patient selection criteria for optimal use of the drug are not well defined. Seven hundred and four first-time coronary artery bypass grafting patients were randomized to receive one of three doses of aprotinin (high, low, and pump-prime-only) or placebo. The patients were stratified as to risk of excessive bleeding. All three aprotinin doses were highly effective in reducing bleeding and transfusion requirements. Consistent efficacy was not, however, demonstrated in the subgroup of patients at low risk for bleeding. There were no differences in mortality or the incidences of renal failure, strokes, or definite myocardial infarctions between the groups, although the pump-prime-only dose was associated with a small increase in definite, probable, or possible myocardial infarctions (p = 0.045). Low-dose and pump-prime-only aprotinin regimens provide reductions in bleeding and transfusion requirements that are similar to those of high-dose regimens. Although safe, aprotinin is not routinely indicated for the first-time coronary artery bypass grafting...Continue Reading

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Citations

Feb 5, 2004·The Annals of Thoracic Surgery·Peter K SmithJoseph Lipscomb
May 15, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Gábor VeresGábor Szabó
May 9, 2000·The Annals of Thoracic Surgery·R AscioneG D Angelini
Nov 28, 2001·The Annals of Thoracic Surgery·J M Murkin
Jun 26, 2003·The Annals of Thoracic Surgery·Antony D GraysonMark A Fox
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Oct 13, 1998·The Annals of Thoracic Surgery·M MisfeldH H Sievers
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Mar 29, 2000·The Annals of Thoracic Surgery·B P BidstrupR N Sapsford
Jul 25, 2003·The Journal of Thoracic and Cardiovascular Surgery·Michele GenoniMarko Turina
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