Effect of aprotinin on clinical outcomes in coronary artery bypass graft surgery: A systematic review and meta-analysis of randomized clinical trials

摘要: Abstract Objective Despite proven blood transfusion benefits, aprotinin may be underused in coronary artery bypass grafting. Reluctance to use stem from safety concerns. The current objective was evaluate clinical outcomes (mortality, myocardial infarction, renal failure, stroke, atrial fibrillation) patients undergoing grafting who receive by performing a quantitative overview of published, randomized, controlled trials. Methods MEDLINE, EMBASE, and PHARMLINE (1988-2001) reference lists relevant articles were searched for studies. Criteria data inclusion as follows: (1) random allocation study treatments, (2) placebo control, (3) enrollment only grafting, (4) no combination with another experimental medication or device, (5) prophylactic continuous intraoperative use. Results Data 35 trials (n = 3879) confirm that reduces requirements (relative risk 0.61, 95% confidence interval 0.58-0.66) relative placebo, 39% reduction. Aprotinin therapy not associated increased decreased mortality 0.96, 0.65-1.40), infarction 0.85, 0.63-1.14), failure 1.01, 0.55-1.83) risk, but it reduced stroke 0.53, 0.31-0.90) trend toward fibrillation 0.90, 0.78-1.03). Conclusions requirements. Concerns is mortality, supported placebo-controlled Evidence tendency reduction occurrence observed received aprotinin.