Evaluation and Comparison of Using Low Dose Aprotinin and Tranexamic Acid in CABGS: A Double –Blinded, Prospective, Randomized Study of 150 Patients

Background. Cardiovascular operations are associated with an inherented bleeding tendency that some time leads to severe bleeding and transfusion requirement. Phar- macologic intervention to minimize post bypass bleeding and blood product transfu- sions has received increasing attention for both medical and economic attention. Methods: In this double-blind randomized placebo-controlled clinical trial, three groups of patients undergoing on-pump Coronary Artery Bypass Surgery(CABG), each group composed of 50 patients, were blindly randomized to receiving either low aprotinin, tranexamic acid or placebo, and then results were evaluated and compared in each group. Results: The following variables were similar in groups and there were no sta- tistically significant differences in these variables: Age(P=0.308), Sex(P=0.973), ypelipidemia(P=0.720),Hypertention(P=0.786),Smoking(P=0.72),Diabetes(P=0.960). The amount of drainage from chest tubes were less in aprotinin and tranexamic acid groups compared to placebo, and this was statistically important(P 0.001). There were no statistically significant differences in need for reoperation for bleeding in three groups(P=0.998). Complications following surgery in three groups were statistically the same and not significantly different (table below). All complications had a good course and all patients were discharged from hospital uneventfully. There were no mor- tality in any group. Conclusions: low dose aprotinin and tranexamic acid can significantly reduce blood loss and transfusion requirement in CABG surgery without importantly increasing mortality and morbidity.