title: Aprotinin for patients exposed to clopidogrel before off-pump coronary bypass.
abstract: To verify whether low-dose aprotinin reduces blood loss and blood product usage in patients with clopidogrel exposure within 5 days before off-pump coronary artery bypass, 51 patients with clopidogrel exposure were randomized in a double-blind fashion to receive low-dose aprotinin (25 patients), or placebo (26 patients). The baseline characteristics and number of distal anastomoses in the patients in each group were comparable. Time between the last dose of clopidogrel and start of the operation was similar in both groups, as was mean left ventricular ejection fraction. Chest tube drainage, blood product usage, and reoperation rate were significantly higher in the placebo group. In patients with unstable angina and recent clopidogrel exposure who are undergoing off-pump coronary artery bypass, intraoperative administration of low-dose aprotinin is recommended to reduce blood loss and transfusion requirements.
authors.affiliation: Division of Cardiovascular Surgery, Central Hospital, Izmir, Turkey. fnurozler@yahoo.com
authors.forename: Feza
authors.initials: F
authors.lastname: Nurözler
authors.forename: Tolga
authors.initials: T
authors.lastname: Kutlu
authors.forename: Güngör
authors.initials: G
authors.lastname: Küçük
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000188:drug therapy*; D007611:Aprotinin / Q000627:therapeutic use*; D001803:Blood Transfusion; D015505:Chest Tubes; D000077144:Clopidogrel; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D004311:Double-Blind Method; D004322:Drainage / Q000295:instrumentation; D004334:Drug Administration Schedule; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D012086:Reoperation; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors
chemical_list: D006490:Hemostatics; D010975:Platelet Aggregation Inhibitors; D007611:Aprotinin; D000077144:Clopidogrel; D013988:Ticlopidine