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J Cardiovasc Thorac Res. 2014;6(3):197-202. doi: 10.15171/jcvtr.2014.011. Epub 2014 Sep 30.

Safety and efficacy of caproamin fides and tranexamic Acid versus placebo in patients undergoing coronary artery revascularization.

Author information

1
Heart Valve Disease Research Center, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
2
Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
3
Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran.

Abstract

INTRODUCTION:

Excessive fibrinolysis contributes to post-cardiopulmonary bypass bleeding. Tranexamic Acid (TXA) and Caproamin Fides are synthetic lysine analogues that inhibit plasminogen-fibrin binding. The present study aimed to compare TXA and Caproamin Fides versus placebo in patients undergoing elective coronary artery revascularization.

METHODS:

We analyzed perioperative data of 300 adult patients undergoing coronary artery revascularization. Patients were randomly allocated to receive TXA (n=100), Caproamin Fides (n=100) or placebo (n=100) during perioperative time. Mediastinal bleeding during the first 24 hours post-operation, transfusion requirement and post-surgical complications were assessed.

RESULTS:

Most descriptive and intra-operative parameters were well comparable between the 3 study groups. Except for mean number of packed red blood cell (PRBC) units transfused during ICU stay (P=0.01), patients in the Caproamin Fides and TXA groups did not show any statistically significant differences regarding transfusion of blood products during peri-operative period. There was no evidence of a significant difference in mediastinal blood loss during the first 24 hours post-operation between the patients receiving TXA or placebo, while patients in the Caproamin Fides group had significantly lower mediastinal bleeding than the other 2 groups (Caproamin Fides vs. placebo, P=0.002, <0.001 and <0.001 at 6, 12 and 24 hours post-operation; Caproamin Fides vs. TXA, P=0.009, 0.003, <0.001 at 6, 12 and 24 hours post-operation). The incidence of postoperative complications were comparable between Caproamin Fides and TXA groups (P>0.05).

CONCLUSION:

In conclusion, Caproamin Fides seems to be superior to TXA regarding the blood saving effects in patients undergoing coronary artery revascularization.

KEYWORDS:

Aminocaproic acid; Antifibrinolytic agents; Coronary artery bypass; Tranexamic acid

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