University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • Surgery (Austin & Northern Health)
  • Surgery (Austin & Northern Health) - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • Surgery (Austin & Northern Health)
  • Surgery (Austin & Northern Health) - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Safety of Perioperative Aprotinin Administration During Isolated Coronary Artery Bypass Graft Surgery: Insights From the ART (Arterial Revascularization Trial).

    Thumbnail
    Download
    Published version (737.1Kb)

    Citations
    Scopus
    Web of Science
    Altmetric
    5
    1
    Author
    Benedetto, U; Altman, DG; Gerry, S; Gray, A; Lees, B; Angelini, GD; Flather, M; Taggart, DP; ART (Arterial Revascularization Trial) Investigators
    Date
    2018-03-03
    Source Title
    Journal of the American Heart Association
    Publisher
    Ovid Technologies (Wolters Kluwer Health)
    Affiliation
    Surgery (Austin & Northern Health)
    Surgery (St Vincent's)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Benedetto, U., Altman, D. G., Gerry, S., Gray, A., Lees, B., Angelini, G. D., Flather, M., Taggart, D. P. & ART (Arterial Revascularization Trial) Investigators (2018). Safety of Perioperative Aprotinin Administration During Isolated Coronary Artery Bypass Graft Surgery: Insights From the ART (Arterial Revascularization Trial).. J Am Heart Assoc, 7 (5), https://doi.org/10.1161/JAHA.117.007570.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256160
    DOI
    10.1161/JAHA.117.007570
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866323
    Abstract
    BACKGROUND: There is still uncertainty about the safety of aprotinin for coronary artery bypass graft surgery. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral versus single internal thoracic artery grafting. Many of the ART patients (≈30%) received perioperative aprotinin. We investigated the association between perioperative aprotinin administration and short-term (in-hospital) and long-term outcomes by performing a post hoc analysis of the ART. METHODS AND RESULTS: Among patients enrolled in the ART (n=3102) from 2004 to 2007, we excluded those who did not undergo surgery (n=18) and those with no information about use of perioperative aprotinin (n=9). Finally, 836 of 3076 patients (27%) received aprotinin. Propensity matching was used to select 536 pairs for final comparison. Aprotinin was also associated with an increased risk of hospital mortality (9 [1.7%] versus 1 [0.2%]; odds ratio, 9.12; 95% confidence interval [CI], 1.15-72.2; P=0.03), intra-aortic balloon pump insertion (37 [6.9%] versus 17 [3.2%]; odds ratio, 2.26; 95% CI, 1.26-4.07; P=0.006), and acute kidney injury (102 [19.0%] versus 76 [14.2%]; odds ratio, 1.42; 95% CI, 1.03-1.97; P=0.03). Aprotinin was not associated with a lower incidence of transfusion (37 [6.9%] versus 28 [5.2%]; odds ratio, 1.34; 95% CI, 0.81-2.23; P=0.25) and reexploration (26 [4.9%] versus 19 [3.5%]; hazard ratio, 1.39; 95% CI, 0.76-2.53; P=0.28). At 5 years, all-cause mortality was significantly increased in the aprotinin group (56 [10.6%] versus 38 [7.3%]; hazard ratio, 1.51; 95% CI, 1.0-2.28; P=0.045). CONCLUSIONS: In the present post hoc ART analysis, aprotinin was associated with a significantly increased risk of early and late mortality. CLINICAL TRIAL REGISTRATION: URL: http://www.isrctn.com. Unique identifier: ISRCTN46552265.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [53039]
    • Surgery (St Vincent's) - Research Publications [430]
    • Surgery (Austin & Northern Health) - Research Publications [406]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors