Effect of tranexamic acid on transfusion requirement in dual antiplatelet-treated anemic patients undergoing off-pump coronary artery bypass graft surgery.
BACKGROUND
Anemia is not rare in patients presenting for coronary artery bypass graft surgery (CABG) and as these patients are frequently on dual antiplatelet therapy (DAPT), the coexisting conditions could potentially increase the risk of bleeding and transfusion. The aim of this study was to evaluate the effect of tranexamic acid (TA) on blood loss and transfusion in preoperatively anemic patients who continued DAPT until within 5 days of off-pump CABG (OPCAB).


RESULTS
Seventy-six anemic patients were randomized into 2 groups: TA group receiving TA (1g bolus followed by infusion at 200mg/h) and a Control group receiving the same volume of saline. The amount of blood loss and transfusion requirement during, and at 4 and 24h after the operation were assessed. Patients' characteristics and operative data were similar between the groups. During the perioperative period, which combined the intraoperative and postoperative 24h data, the TA group received significantly smaller amounts of packed red blood cells and fresh frozen plasma. Total amount of perioperative blood loss was similar between the groups, although the blood loss during the postoperative 4h was significantly less in the TA group.


CONCLUSIONS
TA infusion could reduce the amount of transfusion during the perioperative period in patients with preoperative anemia who continue DAPT until within 5 days of OPCAB.
Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Goyang, Korea.
So Woon
SW
Ahn
Jae Kwang
JK
Shim
Young Nam
YN
Youn
Jong Wook
JW
Song
So Young
SY
Yang
Sung Chan
SC
Chung
Young Lan
YL
Kwak
D000368:Aged; D000740:Anemia / Q000150:complications* / Q000453:epidemiology; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D015897:Comorbidity; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000453:epidemiology / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
D000933:Antifibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014148:Tranexamic Acid