Study uncovers risk with heart bypass surgery drug

Reported by Susan Aldridge, PhD, medical journalist

Aprotinin, a drug used during heart bypass surgery, is linked to increased mortality.
More than four million patients around the world have received aprotinin, a drug which lessens bleeding, most of them during heart bypass surgery. However, in the last year, its safety has been questioned because it appears to cause kidney problems following surgery.

Researchers from the Ischemia Research and Education Foundation in California now report upon survival rates of nearly 4,000 patients having heart bypass surgery in centers around the world. They looked at their use of aprotinin and aminocaproic acid and tranexamic acid, both of which also reduce bleeding. They found the death rate at five years was 20.8 per cent among the aprotinin-treated patients, compared to 12.7 per cent among control patients. In those who were on aminocaproic acid, the death rate was 15.8 per cent and among those on tranexamic acid 14.7 per cent.

Therefore, aprotinin would appear not to be the best option for patients at risk of blood loss during surgery. However, the study is not able to distinguish between those patients who could benefit from aprotinin and those who perhaps did not really need it. It may still have a role for those who are judged to be at risk of severe blood loss.

Source
Journal of the American Medical Association 7th February 2007 Volume 297 pages 528-529

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