Comparison of two doses of aprotinin in patients receiving aspirin before coronary bypass surgery.
This study was designed to evaluate efficacy and tolerability of two different doses of aprotinin in patients receiving aspirin before undergoing coronary artery bypass grafting. Forty-two patients were randomized to receive either placebo (group I), or aprotinin in doses of 4,000,000 KIU (group II) or 6,000,000 KIU (group III). Drug efficacy was determined by measuring postoperative blood loss and transfusion of blood products. Both doses were effective in reducing blood loss and transfusion requirements. Blood loss through thoracotomy drainage was 450 +/- 224, 182 +/- 144, 142 +/- 98 ml, respectively, for control and treatment groups II and III (p = 0.0001). The numbers of patients with blood transfusions were seven (50%), two (17%) and two (17%) for group I and treatment groups II and III, respectively (p = 0.10). Tolerability was excellent and complications few and reversible. In conclusion, high and medium doses of aprotinin were well tolerated and reduced bleeding and transfusion requirements in patients submitted to coronary bypass surgery under the effects of aspirin.
Moran
S V
SV
Department of Cardiovascular Diseases, Catholic University of Chile, Santiago. smoran@med.puc.cl
Lema
G
G
Medel
J
J
Irarrazaval
M J
MJ
Zalaquett
R
R
Garayar
B
B
Flaskamp
R
R
D000328:Adult; D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage* / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004322:Drainage; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011184:Postoperative Period; D011292:Premedication; D011446:Prospective Studies; D012449:Safety; D013908:Thoracotomy; D016896:Treatment Outcome
D006490:Hemostatics; D010975:Platelet Aggregation Inhibitors; D007611:Aprotinin; D001241:Aspirin