Navigation Links
Drug Combo Tied to Kidney Risk With Some Cardiac Surgeries

Aprotinin plus ACE inhibitor associated with renal woes during off-pump surgery, U.K. study finds

THURSDAY, Feb. 7 (HealthDay News) -- While use of the clotting drug aprotinin (Trasylol) appears safe during on-pump cardiac surgeries, combining it with angiotensin-converting enzyme (ACE) inhibitors during off-pump cardiac surgery shows a significant risk of postoperative kidney dysfunction, British researchers say.

The study was prompted by previous research that noted an association between use of aprotinin -- which reduces the risk of bleeding during complicated surgeries -- and renal failure. Drug maker Bayer voluntarily suspended worldwide marketing of aprotinin after preliminary findings from a Canadian study (BART) suggested the drug increased the risk of death. That trial was halted in October 2007. Shortly after that, the U.S. Food and Drug Administration pulled the drug from the American market.

For this study, researchers analyzed the cases of 9,875 cardiac surgery patients. Most of the patients (5,434) had on-pump cardiac surgery, which means their hearts were stopped and they were hooked up to a heart-bypass machine during surgery. The other patients had off-pump cardiac surgery -- doctors operated on their beating hearts.

Among patients who had on-pump surgery, there was no significant association between aprotinin and postoperative renal dysfunction, irrespective of ACE inhibitor use. However, aprotinin was associated with a more than twofold increased risk of renal dysfunction among the 848 patients who had off-pump cardiac surgery and received both aprotinin and ACE inhibitors.

"We recommend that it might be beneficial for patients to discontinue any use of an ACE inhibitor before elective off-pump surgery, particularly patients with a history of renal impairment," wrote Dr. Ronelle Moulton and Kai Zacharowski, from the department of anesthesia, Bristol Royal Infirmary, United Bristol Healthcare Trust.

Their study was published in this week's issue of The Lancet.

A complete analysis of the BART findings will not be known for some time, Dr. Derek Hausenloy, of The Hatter Cardiovascular Institute, University College London Hospital and Medical School, and colleagues wrote in an accompanying comment.

"While waiting for that analysis, the use of aprotinin in the U.S. and in some European countries has been necessarily restricted, with the consequence that some high-risk patients having cardiac surgery might not receive optimum therapy," Hausenloy and colleagues noted.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart surgery.

-- Robert Preidt

SOURCE: The Lancet, news release, Feb. 7, 2008

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Combo Therapy Shows Promise in Treating Brain Tumors
2. Combo Treatment Best for Elderly Lymphoma Patients
3. Combo Therapy Cuts Prostate Cancer Death Rates
4. Drug Combo Halves Death Risk for Severe COPD Patients
5. Aspirin, Hormone Therapy Combo Can Shorten Lives of Prostate Cancer Patients
6. New Combo Treatment Extends Kidney Cancer Survival
7. Drug Combo With Antibiotic May Slow MS Progression
8. Combo PET/CT Scan Helps Spot Breast Cancers Spread
9. Drug Combos Effective Against Rheumatoid Arthritis
10. Drug Combo Boosts Multiple Myeloma Survival
11. CPR, Defibrillator Combo Boosts Cardiac Incident Survival
Post Your Comments:
Related Image:
Drug Combo Tied to Kidney Risk With Some Cardiac Surgeries
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... ... of the well-respected Microsoft Dynamics SL User Group (MSDSLUG). Recognized as Microsoft’s official ... independent group of Microsoft Dynamics SL software users, partners, industry experts and representatives. ...
(Date:11/27/2015)... ... November 27, 2015 , ... The moment ... itself for not only fulfilling the needs of advisers and clients but going ... price and providing top-tier customer service. However, there's always room for improvement, which ...
(Date:11/27/2015)... ... 27, 2015 , ... CBD College is proud to announce that ... awarded accreditation to its Diagnostic Medical Sonography program. CBD College is honored to join ... twelve colleges and universities in the state of California make the cut. CBD College ...
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... Dr. ... Medical Associates, Inc. and Dr. Tucker Bierbaum with Emergency Medicine at St., ... observed that both STEMI and Sepsis conditions present in similar ways and require time-critical ...
(Date:11/27/2015)... ... , ... Indosoft Inc., developer and distributor of the world-class ... (Long Term Support) into its Q-Suite 5.10 product line. , Making the change ... version of Asterisk that will receive not only security fixes, but feature and ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... Nederland, November 26, 2015 ... Een nieuwe aanpak combineert immunotherapie met Bremachlorin-photodynamische ... ) --> ...      (Photo: ) ... Universitair Medisch Centrum (LUMC) blijkt ...
(Date:11/26/2015)... -- 3D bioprinting market is expected to ... report by Grand View Research Inc. Rising prevalence of chronic ... transplantation is expected to boost the market growth, as 3D ... --> 3D bioprinting market is expected to ... report by Grand View Research Inc. Rising prevalence of chronic ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 ... has announced the addition of the  ... in the Global Cell Surface Testing ... Opportunities" report to their offering.  ... the addition of the  "2016 Future ...
Breaking Medicine Technology: