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dc.contributor.authorBenedetto, U
dc.contributor.authorAltman, DG
dc.contributor.authorGerry, S
dc.contributor.authorGray, A
dc.contributor.authorLees, B
dc.contributor.authorAngelini, GD
dc.contributor.authorFlather, M
dc.contributor.authorTaggart, DP
dc.contributor.authorART (Arterial Revascularization Trial) Investigators
dc.date.accessioned2020-12-18T04:21:37Z
dc.date.available2020-12-18T04:21:37Z
dc.date.issued2018-03-03
dc.identifierpii: JAHA.117.007570
dc.identifier.citationBenedetto, 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.
dc.identifier.issn2047-9980
dc.identifier.urihttp://hdl.handle.net/11343/256160
dc.description.abstractBACKGROUND: 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.
dc.languageeng
dc.publisherOvid Technologies (Wolters Kluwer Health)
dc.titleSafety of Perioperative Aprotinin Administration During Isolated Coronary Artery Bypass Graft Surgery: Insights From the ART (Arterial Revascularization Trial).
dc.typeJournal Article
dc.identifier.doi10.1161/JAHA.117.007570
melbourne.affiliation.departmentSurgery (Austin & Northern Health)
melbourne.affiliation.departmentSurgery (St Vincent's)
melbourne.source.titleJournal of the American Heart Association
melbourne.source.volume7
melbourne.source.issue5
dc.rights.licenseCC BY-NC
melbourne.elementsid1312468
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866323
dc.identifier.eissn2047-9980
melbourne.accessrightsOpen Access


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