Document Detail


Effects of aprotinin on short-term and long-term outcomes after coronary artery bypass grafting surgery.
MedLine Citation:
PMID:  20417766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent studies demonstrated that aprotinin use would increase the short-term and long-term mortality and complications after coronary artery bypass grafting (CABG). This study was to investigate effects of aprotinin during isolated primary CABG on short-term and long-term outcomes in Chinese patients. METHODS: We studied 5,103 consecutive Chinese patients who underwent isolated primary CABG from 1999 to 2005. Of all the patients, 4,122 received aprotinin during operation (aprotinin group) and 981 received no aprotinin or other antifibrinolytic therapy (control group). Short-term and long-term mortality and major complications were analyzed with multivariate regression analysis. Propensity adjustment method was used to minimize the selection bias between the two groups, and propensity matching method was used to yield two well-matched groups for further comparison. RESULTS: Blood loss after operation was significantly reduced in the aprotinin group compared with the control group (p < 0.001). Aprotinin use was neither associated with the perioperative mortality (p = 0.45, relative risk, 1.34) or major complications, nor was it associated with long-term mortality (p = 0.21, relative risk, 1.26) and major adverse cardiac and cerebrovascular events (p = 0.82, relative risk, 0.98). After propensity adjustment for the baseline characteristics, we obtained similar results. In addition, comparison between the two well-matched groups showed no significant difference either in baseline characteristics or in short-term and long-term outcomes. CONCLUSIONS: Aprotinin use during isolated primary CABG reduced blood loss significantly, but was not associated with short-term or long-term mortality and complications. Aprotinin use in relatively low-risk CABG patients was effective and safe in a Chinese (Asian) population.
Authors:
Xianqiang Wang; Zhe Zheng; Hushan Ao; Shiju Zhang; Yang Wang; Hao Zhang; Shengshou Hu
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1489-95     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aprotinin / administration & dosage*,  adverse effects
Blood Loss, Surgical / prevention & control*
Case-Control Studies
Cohort Studies
Coronary Artery Bypass / methods*,  mortality
Coronary Disease / mortality,  surgery*
Female
Follow-Up Studies
Hemostatics / administration & dosage,  adverse effects
Hospital Mortality / trends*
Humans
Infusions, Intravenous
Intraoperative Care / methods
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Postoperative Complications / mortality,  physiopathology
Probability
Reference Values
Retrospective Studies
Risk Assessment
Survival Analysis
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hemostatics; 9087-70-1/Aprotinin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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