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Observational studies published in 2006 raised perioperative safety concerns about using aprotinin (Trasylol), an antifibrinolytic serine protease inhibitor, to reduce bleeding risk during coronary artery bypass grafting (CABG). The FDA has since issued a public health advisory on this topic. Now, we have an update on long-term mortality risk with aprotinin from a cohort whose in-hospital outcomes were reported previously (Journal Watch Cardiology Mar 9 2006).
The present analysis focused on 3876 patients (of the original 4374) whose treating centers participated in a 5-year follow-up study. All had undergone CABG and had received aprotinin; a lysine analogue (aminocaproic acid or tranexamic acid); or no antifibrinolytic treatment. Assignmen…