title: Hemostatic efficacy of dipyridamole, tranexamic acid, and aprotinin in coronary bypass grafting.
abstract: Sixty patients (four groups of 15 patients) were entered in a randomized, controlled study to compare the efficacy of prophylactic treatment with dipyridamole, tranexamic acid, and aprotinin to reduce bleeding after elective coronary artery bypass grafting. Only patients with a preoperative platelet count of less than 246 x 10(9)/L were selected because a previous study showed that these individuals are at risk for increased postoperative bleeding. Compared to control subjects, postoperative blood loss 6 hours after operation was significantly reduced by tranexamic acid (674 +/- 411 versus 352 +/- 150 mL; p < 0.05) and by aprotinin (270 +/- 174 mL; p < 0.01). Dipyridamole did not reduce postoperative blood loss and was associated with complications in 3 patients. We conclude that hemostasis after cardiac operations can be improved with tranexamic acid and aprotinin. Dipyridamole appeared to be ineffective.
authors.affiliation: Department of Thoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: R G
authors.initials: RG
authors.lastname: Speekenbrink
authors.forename: A B
authors.initials: AB
authors.lastname: Vonk
authors.forename: C R
authors.initials: CR
authors.lastname: Wildevuur
authors.forename: L
authors.initials: L
authors.lastname: Eijsman
mesh_terms: D007611:Aprotinin / Q000009:adverse effects / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001026:Coronary Artery Bypass; D004176:Dipyridamole / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D006454:Hemoglobins; D004176:Dipyridamole; D014148:Tranexamic Acid; D007611:Aprotinin