Journal article
A Multicenter, Double-Blind, Placebo-Controlled Trial of Aprotinin for Reducing Blood Loss and the Requirement for Donor-Blood Transfusion in Patients Undergoing Repeat Coronary Artery Bypass Grafting
Circulation (New York, N.Y.), v 92(8), pp 2236-2244
15 Oct 1995
PMID: 7554207
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Aprotinin is a serine protease inhibitor that reduces blood loss and transfusion requirements when administered prophylactically to cardiac surgical patients. To examine the safety and dose-related efficacy of aprotinin, a prospective, multicenter, placebo-controlled trial was conducted in patients undergoing repeat coronary artery bypass graft (CABG) surgery.
Methods and Results
Two hundred eighty-seven patients were randomly assigned to receive either high-dose aprotinin, low-dose aprotinin, pump-prime-only aprotinin, or placebo. Drug efficacy was determined by the reduction in donor-blood transfusion up to postoperative day 12 and in postoperative thoracic-drainage volume. The percentage of patients requiring donor–red-blood-cell (RBC) transfusions in the high- and low-dose aprotinin groups was reduced compared with the pump-prime-only and placebo groups (high-dose aprotinin, 54%; low-dose aprotinin, 46%; pump-prime only, 72%; and placebo, 75%; overall
P
=.001). The number of units of donor RBCs transfused was significantly lower in the aprotinin-treated patients compared with placebo (high-dose aprotinin, 1.6±0.2 U; low-dose aprotinin, 1.6±0.3 U; pump-prime-only, 2.5±0.3 U; and placebo, 3.4±0.5 U;
P
=.0001). There was also a significant difference in total blood-product exposures among treatment groups (high-dose aprotinin, 2.2±0.4 U; low-dose aprotinin, 3.4±0.9 U; pump-prime-only, 5.1±0.9 U; placebo, 10.3±1.4 U). There were no differences among treatment groups for the incidence of perioperative myocardial infarction (MI).
Conclusions
This study demonstrates that high- and low-dose aprotinin significantly reduces the requirement for donor-blood transfusion in repeat CABG patients without increasing the risk for perioperative MI.
Metrics
Details
- Title
- A Multicenter, Double-Blind, Placebo-Controlled Trial of Aprotinin for Reducing Blood Loss and the Requirement for Donor-Blood Transfusion in Patients Undergoing Repeat Coronary Artery Bypass Grafting
- Creators
- Jerrold H. Levy - Emory UniversityRoque Pifarre - Loyola University ChicagoHartzell V. Schaff - Cardiovascular SurgeryJan C. Horrow - Drexel UniversityRobert Albus - Virginia Heart Surgery AssociatesBruce Spiess - University of WashingtonTodd K. Rosengart - Cornell UniversityJeffrey Murray - University of Michigan–Ann ArborRichard E. Clark - Allegheny General HospitalPeter Smith - Duke UniversityAndrea Nadel - BayerSharon L. Bonney - BayerRobert Kleinfield - BayerJay C Horrow - Anesthesiology and Perioperative Medicine
- Publication Details
- Circulation (New York, N.Y.), v 92(8), pp 2236-2244
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:A1995TA12500036
- Scopus ID
- 2-s2.0-0028792021
- Other Identifier
- 991019184290704721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Peripheral Vascular Disease