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Trasylol Tied to nephritic dysfunction, study says

Posted by Administrator (admin) on Feb 13 2008 at 4:10 PM
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The use of clotting drug Trasylol is considered safe during on-pump cardiac surgeries. However, some researchers from the U.K. warn that combining the drug with ACE (Angiotensin Converting Enzyme) inhibitors during off-pump cardiac surgery poses a potential risk of postoperative kidney dysfunction.

The researchers revealed this after a study conducted on thousands of cardiac surgery patients. A previous study had found a connection between use of Trasylol, the drug which can reduce the risk of bleeding during complicated surgeries, and nephritic failure.

The initial findings of a Canadian study (BART) also had proved that the drug increases the risk of death. It was after this study that drug maker Bayer voluntarily stopped worldwide marketing of the drug. The U.S. Food and Drug Administration also pulled Trasylol from American market.

For the recent study, the British researchers analyzed 9,875 cases of cardiac surgery. Majority of the patients (more than 5,000) had on-pump cardiac surgery. During on-pump surgery, the hearts of the patients are stopped and hooked up to a heart-bypass machine. The other patients had undergone off-pump cardiac surgery (in which doctors operate the beating hearts of the patients).

The researchers said that there was no considerable connection between Trasylol and postoperative renal dysfunction among the patients who had undergone on-pump surgery (regardless of the use of ACE inhibitor). But the drug was associated with increased risk of nephritic dysfunction among 848 patients who had off-pump cardiac surgery and received ACE inhibitors and Trasylol.

Dr. Ronelle Moulton and Kai Zacharowski, from the department of anesthesia, Bristol Royal Infirmary, United Bristol Healthcare Trust recommend it might be beneficial for patients to stop the use of an ACE inhibitor before elective off-pump surgery, particularly for those patients who have a history of renal impairment.

The study has been published in the last issue of ‘The Lancet’.

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