There have been rising acute safety concerns regarding certain hemorrhage-sparing medications in cardiac surgery. The objective of this study is to contrast long-term all-cause mortality in patients undergoing acute artery bypass graft (CABG) by using the serotonin inhibitor aprotinin.

This is an observational study of mortality conducted by following index hospitalization of patients across 69 medical centers and prospectively assessing survival at six weeks, six months, and five years after CABG surgery. The researchers compared the associations of all-cause mortality with the use of hemorrhage-sparing medications. The primary outcome measure of the study was all-cause death over a span of 5 years.

 When compared with control (128 deaths among 1,009 patients – 12.7%), aprotinin treatment was associated with substantially increased mortality (223 deaths among 1,072 patients – 20.8%). In patients with or without propensity adjustment, aprotinin was predictive of 5-year mortality among patients with diverse risk profiles and those who survived their index hospitalization.

 The findings of this research indicated that aprotinin use is associated with an increased risk of long-term mortality following CABG surgery. However, the use of aprotinin among patients undergoing CABG surgery is less prudent because of the availability of less expensive and safer alternatives.

Ref: https://jamanetwork.com/journals/jama/fullarticle/205404