Myocardial infarction aprotinin

A meta-analysis of placebo-controlled trials of desmopressin in 702 cardiac surgery patients showed a significantly increased risk of myocardial infarction in treated patients (RR = 2.39, Cl = 1.02, 5.60) (30). Overall mortality was not different from placebo. Desmopressin was less efficacious in reducing perioperative blood loss than either aprotinin or lysine analogues. 

In a randomized, placebo-controUed, multicenter study of aprotinin in coronary artery bjrpass surgery, there was no increase in mortality or the incidence of myocardial infarction (20). 

In a single-center non-randomized study in patients undergoing primary cardiac operations, 3334 were given aprotinin and 3417 were not [203 ]. The former were older, and had more unstable symptoms, lower ejection fractions, more preoperative hemodynamic support, more urgent operations, and more combined coronary or valvular operations. Postoperative bleeding and blood product transfusion were considerably reduced by aprotinin, as was median duration of mechanical ventilation. Aprotinin was not related to postoperative myocardial infarction, renal insufficiency, neurological dysfunction, or operative death. 

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