CMAJ • January 20, 2009; 180 (2). First published December 2, 2008; doi:10.1503/cmaj.081109
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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The safety of aprotinin and lysine-derived antifibrinolytic drugs in cardiac surgery: a meta-analysis

David Henry, MBChB, Paul Carless, BHSc MMedSc (ClinEpid), Dean Fergusson, PhD MHA and Andreas Laupacis, MD MSc

From the School of Medicine and Public Health (Henry, Carless), University of Newcastle, Australia; the Ottawa Health Research Institute (Fergusson), The Ottawa Hospital, Ottawa, Ont.; the Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital (Laupacis); the Institute for Clinical Evaluative Sciences (Henry, Laupacis); and the Faculty of Medicine (Henry, Laupacis), University of Toronto, Toronto, Ont.


Figure 117
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  		Figure 1: Selection of studies for inclusion in the meta-analysis of the use of aprotinin and lysine analogues in cardiac surgery. Note: ISPOT = International Study of Perioperative Transfusion.

 

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  		Table 1.

 

Figure 217
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  		Figure 2: Meta-analyses of myocardial infarction in placebo or inactive randomized controlled trials of the use of aprotinin in cardiac surgery (I2 = 0%, Z = 0.46). References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.

 

Figure 317
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  		Figure 3: Meta-analyses of myocardial infarction in placebo or inactive randomized controlled trials of the use of tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) in cardiac surgery (TXA v. control I2 = 0%, Z = 0.41; EACA v. control I2 = 12.4%, Z = 0.25; aprotinin, TXA and EACA v. control I2 = 0%, Z = 0.66). References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.

 

Figure 417
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  		Figure 4: Meta-analyses of myocardial infarction in head-to-head randomized controlled trials of the use of aprotinin and tranexamic acid (TXA) in cardiac surgery (I2 = 0%, Z = 0.02). References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.

 

Figure 517
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  		Figure 5: Meta-analyses of mortality in randomized placebo or inactive controlled trials of aprotinin (I2 = 0%, Z = 0.49). References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.

 

Figure 617
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  		Figure 6: Meta-analyses of mortality in randomized placebo or inactive controlled trials of tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) (TXA v. control I2 = 0%, Z = 1.43; EACA v. control I2 0%, Z = 0.83; aprotinin, TXA and EACA v. control I2 = 0%, Z = 0.73. References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.

 

Figure 717
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  		Figure 7: Meta-analyses of mortality in head-to-head randomized controlled trials of the use of aprotinin and tranexamic acid (TXA) in cardiac surgery (I2 = 0%, Z = 1.85). References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.

 

Figure 817
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  		Figure 8: Meta-analyses of mortality in head-to-head randomized controlled trials of the use of aprotinin and epsilon aminocaproic acid (EACA) in cardiac surgery (I2 = 0%, Z = 1.86). References available in Appendix 1 (www.cmaj.ca/cgi/content/full/180/2/183/DC2). Note: CI = confidence interval, NA = not applicable.