Tranexamic Acid in Patients Undergoing Noncardiac Surgery
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2022;10(7):5 N Engl J Med. 2022 Apr 2.What this means for my practice?
The results of this study found that tranexamic acid administered before and after non-cardiac surgery had a lower likelihood of life-threatening bleeding, major bleeding or bleeding in a critical organ. However, tranexamic acid was not observed to be non-inferior to placebo for the likelihood of the composite cardiovascular events. This study was limited by the early stoppage of the trial due to slowed recruitment, however, more than 95% of the planned sample size was recruited.
Study Summary
9535 patients undergoing non-cardiac surgery were randomized to receive tranexamic acid (n=4757) or placebo (n=4778) at the start and end of surgery. The primary efficacy outcome was a composite bleeding outcome of life-threatening bleeding, major bleeding, or bleeding into a critical organ. The primary safety outcome was a composite endpoint of myocardial injury, non-hemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism, which was tested for non-inferiority vs. placebo. The results of the trial found a significantly lower rate of composite bleeding events in the tranexamic acid group vs. placebo (9.1% vs. 11.7%, p<0.001). However, the non-inferiority of tranexamic acid was not established for the composite cardiovascular safety outcome (14.2% vs. 13.9%, p=0.04 [p<0.025 required for non-inferiority]).
Unlock the Full ACE Report
You have access to 4 more FREE articles this month.
Click below to unlock and view this ACE Reports
Unlock Now
Critical appraisals of the latest, high-impact randomized controlled trials and systematic reviews in orthopaedics
Access to OrthoEvidence podcast content, including collaborations with the Journal of Bone and Joint Surgery, interviews with internationally recognized surgeons, and roundtable discussions on orthopaedic news and topics
Subscription to The Pulse, a twice-weekly evidence-based newsletter designed to help you make better clinical decisions
Exclusive access to original content articles, including in-house systematic reviews, and articles on health research methods and hot orthopaedic topics
Or upgrade today and gain access to all OrthoEvidencecontent for as little as $1.99 per week.
Already have an account? Log in
Are you affiliated with one of our partner associations?
Click here to gain complimentary access as part your association member benefits!
0 of 4 monthly FREE articles unlocked
