A randomized, double-blinded trial comparing the effectiveness of tranexamic acid and epsilon-aminocaproic acid in reducing bleeding and transfusion in cardiac surgery

Jonathan D. Leff, Amanda Rhee, Singh R. Nair, Daniel Lazar, Sudheera Sathyanarayana, Linda Shore-Lesserson

Research output: Contribution to journalArticle

Abstract

Objectives: To compare the effectiveness of epsilon aminocaproic acid (EACA) to tranexamic acid (TA) in reducing blood loss and transfusion requirements in patients undergone cardiac surgery under cardiopulmonary bypass. Design: Randomized, double blinded study. Outcome variables collected included; baseline demographic characteristics, type of surgery, amount of 24 hour chest tube drainage, amount of 24 hour blood products administered, 30 day mortality and morbidity and length of stay. We analyzed the data using parametric and non-parametric tests as appropriate. Setting: Single center tertiary-care university hospital setting. Participants: 114 patients who had undergone cardiac surgery under cardiopulmonary bypass. Interventions: Standard dose of intra-operative EACA or TA was compared in patients undergone cardiac surgery under cardiopulmonary bypass. Results: There was no statistically significant difference between groups when analyzing chest tube drainage. However, there was a significant difference in the administration of any transfusion (PRBC's, FFP, platelets) intra-operatively to 24 hours postoperatively, with less transfusion in patients receiving EACA compared to TA (25% vs. 44.8%, respectively P = 0.027). Additionally, there was no significant difference in terms of adverse events during the one month follow up period. Conclusion: The findings of this study suggest that EACA and TA have similar effects on chest tube drainage but EACA is associated with fewer transfusions in CABG alone surgeries. Our results suggest that EACA can be used in a similar fashion to TA which may result in a cost and morbidity advantage.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalAnnals of Cardiac Anaesthesia
Volume22
Issue number3
DOIs
StatePublished - Jul 1 2019

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Tranexamic Acid
Aminocaproic Acid
Thoracic Surgery
Hemorrhage
Chest Tubes
Cardiopulmonary Bypass
Drainage
Morbidity
Tertiary Care Centers
Blood Transfusion
Length of Stay
Blood Platelets
Demography
Costs and Cost Analysis
Mortality

Keywords

  • Coronary artery bypass graft surgery
  • epsilon aminocaproic acid
  • epsilon-aminocaproic acid
  • tranexamic acid
  • tranexamic acid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

A randomized, double-blinded trial comparing the effectiveness of tranexamic acid and epsilon-aminocaproic acid in reducing bleeding and transfusion in cardiac surgery. / Leff, Jonathan D.; Rhee, Amanda; Nair, Singh R.; Lazar, Daniel; Sathyanarayana, Sudheera; Shore-Lesserson, Linda.

In: Annals of Cardiac Anaesthesia, Vol. 22, No. 3, 01.07.2019, p. 265-272.

Research output: Contribution to journalArticle

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