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Aprotinin, drug used in cardiac surgery, heightens death risk: study

Feb 7, 2007 | AFP Researchers have found that as drug used to staunch blood loss in patients undergoing cardiac surgery can raise the risk of death over the medium term. According to a new study published in the February 7 issue of the Journal of the American Medical Association, the drug, aprotinin, was used on more than four million people worldwide since 1985 mainly for heart surgery.

Scientists from the Ischemia Research and Education Foundation in San Bruno, California found that aprotinin is associated with a increased risk of death in the five years after the surgery.

Their observational study of 3,876 patients at 62 medical centers around the world showed aprotinin use "was associated with a doubling to tripling of the risk of perioperative renal (kidney) dysfunction and failure requiring dialysis in patients undergoing primary, repeat or complex coronary artery surgery," the scientists said in a summary of the study.

"We estimate that over the past year, aprotinin was prescribed worldwide to at least 200,000 cardiac surgery patients having a profile similar to patients in our study," they said.

"For such patients, our study found a five percent absolute increase in five-year mortality (one percent per year for five years) associated with aprotinin use."

"Use of aprotinin among patients undergoing (coronary artery bypass graft) surgery does not appear prudent because safer and less expensive alternatives (i.e., aminocaproic acid and tranexamic acid) are available," the authors conclude.

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