Moderate Dose of Tranexamic Acid and Complications after Valvular Heart Surgery.
Journal
The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
medline:
7
4
2023
pubmed:
5
3
2021
entrez:
4
3
2021
Statut:
ppublish
Résumé
In valvular open-heart surgery, data regarding the effect of a moderate dose of tranexamic acid (TXA) on clinical outcomes are limited. Out of a cohort of 13,293 patients, we performed a propensity-score-matched analysis in 6,106 patients and assessed the risk of convulsive seizures (CS, primary endpoint), stroke, renal replacement therapy, and mortality (secondary endpoints). In the entire study cohort of 13,293 patients, we also assessed the multivariable-adjusted association of CS with postoperative outcomes. The risk of CS was significantly higher in the TXA group (2.4%; A moderate TXA dose was associated with a significantly higher risk of seizure, but not with other clinical complications such as stroke, renal replacement therapy, and mortality. However, in the small group of patients experiencing a seizure, the risks of stroke and short- and mid-term mortality were substantially higher than in patients not experiencing a seizure, indicating that the use of a low-dose TXA protocol (<25 mg/kg body weight) should be considered.
Sections du résumé
BACKGROUND
In valvular open-heart surgery, data regarding the effect of a moderate dose of tranexamic acid (TXA) on clinical outcomes are limited.
METHODS
Out of a cohort of 13,293 patients, we performed a propensity-score-matched analysis in 6,106 patients and assessed the risk of convulsive seizures (CS, primary endpoint), stroke, renal replacement therapy, and mortality (secondary endpoints). In the entire study cohort of 13,293 patients, we also assessed the multivariable-adjusted association of CS with postoperative outcomes.
RESULTS
The risk of CS was significantly higher in the TXA group (2.4%;
CONCLUSION
A moderate TXA dose was associated with a significantly higher risk of seizure, but not with other clinical complications such as stroke, renal replacement therapy, and mortality. However, in the small group of patients experiencing a seizure, the risks of stroke and short- and mid-term mortality were substantially higher than in patients not experiencing a seizure, indicating that the use of a low-dose TXA protocol (<25 mg/kg body weight) should be considered.
Identifiants
pubmed: 33662990
doi: 10.1055/s-0041-1724035
doi:
Substances chimiques
Tranexamic Acid
6T84R30KC1
Antifibrinolytic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
181-188Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
None.