Journal article
Effect of tranexamic acid on platelet ADP during extracorporeal circulation
American journal of hematology, v 38(2), pp 113-119
Oct 1991
PMID: 1951300
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Seventeen adults received the antifibrinolytic drug tranexamic acid during cardiac surgery utilizing extracorporeal circulation (ECC). In 8 patients, drug administration began prior to skin incision (pre‐ECC); infusions commenced after ECC and protamine administration in another 9 patients (post‐ECC). Compared with the post‐ECC group, the pre‐ECC group exhibited less bleeding via mediastinal drains (420 vs. 655 mL/12 h median, P = 0.024), decreased frequency of the presence (≥10 γg/mL) of fibrin split products (P < 0.05), and greater platelet dense granule content of adenosine diphosphate after surgery (15.47 vs. 4.05 nmoles/mg protein median, P = 0.021).
Follow‐up in vitro study of tranexamic acid inhibition of plasmin‐induced platelet activation utilizing normal human platelet rich plasma and porcine plasmin revealed a 13‐fold lower concentration of tranexamic acid for 50% inhibition when plasmin was preincubated with the drug (1.2 γg/mL, 95% CI = 1.13 – 1.60 γg/mL) compared to when platelet rich plasma was preincubated with the drug (16 γg/mL, 95% CI = 7.3 – 99. γg/mL). Plasmin inactivated with tranexamic acid retained its ability to inhibit thrombininduced platelet activation, thus suggesting that tranexamic acid inhibits plasmin's catalytic activity and not its binding to platelets.
Both clot lysis and platelet dysfunction may contribute to bleeding after ECC. Tranexamic acid blocks plasmin‐induced partial platelet activation during ECC, thus preserving platelet function and promoting hemostasis after ECC.
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Details
- Title
- Effect of tranexamic acid on platelet ADP during extracorporeal circulation
- Creators
- Gerald SoslauJan HorrowIsadore Brodsky
- Publication Details
- American journal of hematology, v 38(2), pp 113-119
- Publisher
- Wiley Subscription Services, Inc., A Wiley Company; New York
- Number of pages
- 7
- Grant note
- Mary L. Smith Charitable Lead Trust (04269‐06‐J)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:A1991GJ12500007
- Scopus ID
- 2-s2.0-0026076589
- Other Identifier
- 991014878327304721
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- Web of Science research areas
- Hematology