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Platelet-sparing properties of aprotinin: A scoping review on mechanisms and clinical effects.
Eur J Anaesthesiol
January 2025
From the Department of Cardiovascular Sciences, KU Leuven (LLWV, SR, RVdE), and the Department of Anesthesiology, University Hospital of the KU Leuven, Leuven, Belgium (LLWV, SR, RVdE).
Background: Cardiac surgery involving cardiopulmonary bypass (CPB) is associated with the risk of acquired coagulopathy, including dysregulated fibrinolysis, which can result in life-threatening bleeding complications. Aprotinin, an antifibrinolytic agent, has been recommended for the prevention of these complications. Its effectiveness has been attributed to its ability to nonspecifically inhibit various serine proteases involved in the coagulation and fibrinolysis cascade.
View Article and Find Full Text PDFLiposome-encapsulated aprotinin biodistribution in mice: Side-by-side comparison with free drug formulation.
Biochem Biophys Res Commun
November 2024
ChemRar RDI, LLC, 40 Bolshoy Blvd, 121205, Moscow, Russia.
Injuries of the respiratory system caused by viral infections (e.g., by influenza virus, respiratory syncytial virus, metapneumovirus, or coronavirus) can lead to long-term complications or even life-threatening conditions.
View Article and Find Full Text PDFCost analysis study comparing the impact of treatment with aprotinin versus tranexamic acid in cardiac surgery under cardiopulmonary bypass.
Ann Pharm Fr
November 2024
CHU de Bordeaux, unité de pharmacie clinique, service pharmacie à usage intérieur, avenue de Magellan, 33604 Pessac, France; Université Bordeaux, Inserm Bordeaux Population Health Research Center team Pharmacoepidemiology, UMR 1219, université de Bordeaux, Case 11, 146, rue Léo-Saignat, 33076 Bordeaux, France; Université Bordeaux, Inserm, biologie des maladies cardiovasculaires, U1034, avenue de Magellan, 33600 Pessac, France. Electronic address:
Article Synopsis
- Aprotinin was taken off the market in 2008 due to safety concerns but was reintroduced in France in 2018. A study was conducted to compare its effectiveness with tranexamic acid in high-risk cardiac surgery patients.
- Economic analysis showed no significant difference in overall costs between the two treatments, but the tranexamic acid group incurred higher costs for blood products.
- The initial higher cost of aprotinin is compensated by the greater expenses of blood products required for patients treated with tranexamic acid.
Aprotinin in high-risk isolated coronary artery bypass graft patients: a 3-year propensity matched study.
J Cardiothorac Surg
July 2024
Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals Trust, Cottingham, UK.
Background: Aprotinin, a serine protease inhibitor, has been used variably in cardiac surgery amidst ongoing debates about its safety following several previous studies. This study assesses the outcomes of aprotinin in high-risk isolated Coronary Artery Bypass Graft (iCABG) patients.
Methods: The study retrospectively analysed a cohort of 1026 iCABG patients, including 51 patients who underwent aprotinin treatment.
Strategies to attenuate maladaptive inflammatory response associated with cardiopulmonary bypass.
Front Surg
July 2024
Division of Cardiothoracic Surgery, Department of Surgery, Brown University/Rhode Island Hospital, Providence, RI, United States.
Cardiopulmonary bypass (CPB) initiates an intense inflammatory response due to various factors: conversion from pulsatile to laminar flow, cold cardioplegia, surgical trauma, endotoxemia, ischemia-reperfusion injury, oxidative stress, hypothermia, and contact activation of cells by the extracorporeal circuit. Redundant and overlapping inflammatory cascades amplify the initial response to produce a systemic inflammatory response, heightened by coincident activation of coagulation and fibrinolytic pathways. When unchecked, this inflammatory response can become maladaptive and lead to serious postoperative complications.
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