Journals / Turkish Journal of Medical Sciences / 2017 / Cilt: 47 - Sayı: 6

Emergency coronary bypass surgery in patients under the influence of dualantiplatelet therapy: effects of tranexamic acid and desmopressin acetate

Pages
1708–1714
Publication Date
2022-11-04
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Use of TnX-A infusion alone in these patient groups had a positive effect on hemostasis-related data

📌 3 Key Takeaways

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Objective & Hypothesis:Background/aim: Bleeding in patients undergoing coronary artery bypass grafting (CABG) while using dual antiplatelet therapy (DAPT) is a cause of significant morbidity and mortality.
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Key Findings & Data:Fifty-four patients were enrolled and classified into 4 different groups.
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Conclusion & Impact:Use of TnX-A infusion alone in these patient groups had a positive effect on hemostasis-related data
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Background/aim: Bleeding in patients undergoing coronary artery bypass grafting (CABG) while using dual antiplatelet therapy (DAPT) is a cause of significant morbidity and mortality. The aim of this study is to examine the perioperative hemostatic effects of tranexamic acid (TnX-A) and desmopressin acetate (Des) in these patients. Materials and methods: This clinical study was planned in a prospective and randomized manner. Fifty-four patients were enrolled and classified into 4 different groups. They were compared in terms of various bleeding and transfusion parameters. Results: No significant differences were observed between the groups in pre/intraoperative data apart from closure times. Plasmin/α-2 antiplasmin complex values in the TnX-A and control groups were significantly higher than those in the Des and TnX-A+Des groups at the end of postoperative drug infusion. Mean duration of closure times, first 3-h and total postoperative amounts of drainage, administered volumes of erythrocyte suspension/fresh frozen plasma, cost of blood products, length of intubation, length of stay in the intensive care unit, and time to discharge were also significantly higher in the Des and control groups. Conclusion: Des had no significant effect on bleeding control and even delayed the hemostatic efficacy of TnX-A. Use of TnX-A infusion alone in these patient groups had a positive effect on hemostasis-related data

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Cite This Article

ALTUN, G., HEMŞİNLİ, D., PULATHAN, Z., CİVELEK, A. (2022). Emergency coronary bypass surgery in patients under the influence of dualantiplatelet therapy: effects of tranexamic acid and desmopressin acetate. Turkish Journal of Medical Sciences, Cilt: 47 - Sayı: 6, 1708–1714. https://ajindex.com/articles/610605

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References (12)

  1. Shore-Lesserson L, Manspeizer HE, DePerio M, Francis S, Vela-Cantos F, Ergin MA. Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anest Analg 1999; 88: 312-319
  2. Purkayastha S, Athanasiou T, Malinovski V, Tekkis P, Foale R, Casula RA, Glenville B, Darzi A. Does clopidogrel affect outcome after coronary artery bypass grafting? A metaanalysis. Heart 2006; 92: 531-532
  3. Leong JY, Baker RA, Shah PJ, Cherian VK, Knight JL. Clopidogrel and bleeding after coronary artery bypass graft surgery. Ann Thorac Surg 2005; 80: 928-933
  4. Karabulut H, Toraman F, Evrenkaya S, Goksel O, Tarcan S, Alhan C. Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery. Eur J Cardiothorac Surg 2004; 25: 419-423
  5. Yende S, Wunderink RG. Effect of clopidogrel on bleeding after coronary artery bypass surgery. Crit Care Med 2001; 29: 2271- 2275
  6. Hongo RH, Ley J, Dick SE, Yee RR. The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting. J Am Coll Cardiol 2002; 40: 231-237
  7. Englberger L, Faeh B, Berdat PA, Eberli F, Meier B, Carrel T. Impact of clopidogrel in coronary artery bypass grafting. Eur J Cardiothorac Surg 2004; 26: 96-101
  8. Ascione R, Ghosh A, Rogers CA, Cohen A, Monk C, Angelini GD. In hospital patients exposed to clopidogrel before coronary artery bypass graft surgery: a word of caution. Ann Thorac Surg 2005; 79: 1210-1216
  9. Kolh P, Windecker S, Alfonso F, Collet JF, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for CardioThoracic Surgery (EACTS). Eur J Cardiothorac Surg 2014; 46: 517-592
  10. Kunadian B, Thornley AR, Tanos M, Dunning J. Should clopidogrel be stopped prior to urgent cardiac surgery? Interact Cardiovasc Thorac Surg 2006; 5: 630-636
  11. Plicner D, Mazur P, Hymczak H, Stolinski J, Litwinowicz R, Drwila R, Undas A. Preoperative platelet aggregation predicts perioperative blood loss and rethoracotomy for bleeding in patients receiving dual antiplatelet treatment prior to coronary surgery. Thromb Res 2015; 136: 519-525
  12. Casati V, Gerli C, Franco A, Torri G, D’Angelo A, Benussi S, Alfieri O. Tranexamic acid in off-pump coronary surgery: a preliminary, randomized, double-blind, placebo-controlled study. Ann Thorac Su