Reduction of blood activation in patients receiving aprotinin during cardiopulmonary bypass for coronary artery surgery

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
C BaufretonD Y Loisance

Abstract

Aprotinin reduces blood loss after cardiac surgery, particularly in patients taking aspirin. This study was performed to evaluate whether the reduction of contact phase activation by aprotinin is related to decreased complement activation during blood activation. Two hundred patients were prospectively operated on for coronary artery bypass. Aprotinin was used in the cardiopulmonary bypass (CPB) prime if aspirin was not discontinued 10 days before surgery and in patients undergoing second operation (n = 102). Blood loss was significantly reduced in patients receiving aprotinin (596 +/- 309 ml vs 754 +/- 329 ml without aprotinin; p = 0.0001), as was the need for transfusion (13% vs 34% without aprotinin; p = 0.0001) after surgery. Blood activation has been studied in 60 patients. Multivariate analysis showed that contact phase activation, as assessed by maximum values of C1 inhibitor/kallikrein complexes, was reduced by aprotinin treatment (p < 0.0001). Fibrinolytic activity decreased with aprotinin treatment, as reflected by lower values of D-dimers at the end of CPB (p < 0.0001). In addition, thrombin generation, as assessed by F1 + 2 scission peptide, was reduced by aprotinin (p = 0.01). However, the stepwise regression model...Continue Reading

Citations

May 13, 1999·The Annals of Thoracic Surgery·C BaufretonD Y Loisance
Sep 13, 2002·Biotechnology and Bioengineering·Adriano R AzzoniZivko L Nikolov
Jan 6, 1999·The Annals of Thoracic Surgery·C BaufretonD Y Loisance
Sep 15, 2001·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·D J CampbellJ D Santamaria

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