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:: Volume 10, Issue 2 (3-2019) ::
Caspian J Intern Med 2019, 10(2): 156-161 Back to browse issues page
The effect of low- dose tranexamic acid on postoperative blood loss in patients treated with clopidogrel and aspirin
Nadia Banihashem , Moghadam khorasani , Hamidreza Vaffai , Fereshteh Naziri , Soraya Khafri , Shahram Seyfi
Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran , ficu_ss@yahoo.com
Abstract:   (393 Views)
Background: Clopidogrel in combination with aspirin increases bleeding, allogeneic red cell transfusion and reoperation rates after CABG. Tranexamic acid, an antifibrinolytic agent, has been approved for use in cardiac surgery to reduce bleeding. In the present study, we evaluated the impact of tranexamic acid on the transfusion and post-operative blood loss after CABG in patients treated with clopidogrel less than 5 days before surgery.
Methods: This study was a prospective, randomized, double-blinded clinical trial. Patients undergoing on-pump CABG with their last dose of clopidogrel and aspirin less than 5 days preoperatively were randomly assigned to receive tranexamic acid (10 mg/kg before surgical incision and 10 mg/kg after protamine neutralization) or a corresponding volume of saline solution. The incidence of allogeneic red cell transfusion and 48h postoperative blood loss were recorded.
Results: The average volume of blood loss was 776.92±459.81mL for the TXA group and 1075.00±670.91mL for the control group (P=0.03) in the patients with clopidogrel exposure within 48 h before surgery. The average volume of blood loss was not different between two groups in the patients with clopidogrel exposure within 5 days before surgery and also transfusion rate.
Conclusion: The result of this study shows that tranexamic acid reduced blood loss in the patients with clopidogrel exposure within 48 h before surgery. So, it is better that we use tranexamic acid before surgery in all patients.
Keywords: Coronary arteries bypass grafting, clopidogrel, tranexamic acid, post-operative bleeding, transfusion
Full-Text [PDF 319 kb]   (46 Downloads)    
Type of Study: Original Article | Subject: Surgery
Received: 2018/01/16 | Accepted: 2019/02/3 | Published: 2019/05/13
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Banihashem N, khorasani M, Vaffai H, Naziri F, Khafri S, Seyfi S. The effect of low- dose tranexamic acid on postoperative blood loss in patients treated with clopidogrel and aspirin. Caspian J Intern Med. 2019; 10 (2) :156-161
URL: http://caspjim.com/article-1-1369-en.html


Volume 10, Issue 2 (3-2019) Back to browse issues page
Caspian Journal of Internal Medicine
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