The efficacy and safety of epsilon-aminocaproic acid treatment in patients with cirrhosis and hyperfibrinolysis

Aliment Pharmacol Ther. 2006 Jan 1;23(1):115-20. doi: 10.1111/j.1365-2036.2006.02730.x.

Abstract

Background: Patients with decompensated cirrhosis are at risk for hyperfibrinolysis; this is potentially fatal. epsilon-aminocaproic acid has been used to treat patients with hyperfibrinolysis; however, the data about its benefit in the setting of cirrhosis are minimal.

Aim: To analyse the efficacy of epsilon-aminocaproic acid and its safety in cirrhotic patients with hyperfibrinolysis.

Methods: All patients with an abnormal euglobin lysis time who were admitted to Rancho Los Amigos Medical Center from 1 January 2001 to 31 December 2002 were included in the study. Their medical records were reviewed and analysed.

Results: There were 60 cirrhotic patients with shortened euglobin lysis time. Fifty-two patients received epsilon-aminocaproic acid. Of the 52 patients, seven had one or more bleeding episodes with the subcutaneous or soft tissue bleeding as the most common indication for epsilon-aminocaproic acid use. Of the 37 patients, 34 (92%) had improvement or resolution of their bleeding. Only two (3%) patients had epsilon-aminocaproic acid treatment discontinued because of minor side effects, rash and lightheadedness. There were no thromboembolic complications of treatment.

Conclusions: epsilon-aminocaproic acid was found to be effective and safe for treatment of hyperfibrinolysis in patients with cirrhosis.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aminocaproic Acid / therapeutic use*
  • Antifibrinolytic Agents / therapeutic use*
  • Female
  • Fibrinolysis / drug effects*
  • Hemorrhage / prevention & control
  • Humans
  • Liver Cirrhosis / drug therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Serum Globulins / drug effects

Substances

  • Antifibrinolytic Agents
  • Serum Globulins
  • Aminocaproic Acid