Drug used in heart surgery may increase the risk of death

HealthDay News: Patients given aprotinin, a drug used to limit blood loss in heart bypass surgery, are at greater risk of dying over the next five years than those given two other medications, a new study finds.

The report, published in the Feb. 7 issue of the Journal of the American Medical Association, comes from the same group that last year linked aprotinin to an increased risk of kidney failure, heart failure and stroke.

"Our present findings deal with death," said study author Dr. Dennis T. Mangano, director of the Ischemia Research and Education Foundation, a California-based nonprofit group. "The death rate for aprotinin patients far outstrips that for the other two drugs."

The study tracked the long-term survival of nearly 3,900 heart patients who underwent coronary artery bypass surgery at 62 medical centers worldwide. The researchers tabulated survival at six weeks, six months, and then annually for five years.
The five-year death rate for patients given aprotinin was 20.8 percent, compared to 15.8 percent for those given another drug, aminocaproic acid, and 14.7 percent for those given tranexamic acid. Both alternative drugs are available in generic versions.

Aprotinin was approved for use in high-risk cardiac surgery patients by the U.S. Food and Drug Administration in 1993. After last year's report from Mangano's group, the FDA advised doctors to carefully monitor aprotinin patients for kidney, heart and brain damage -- an action taken after Bayer Pharmaceuticals, which markets the drug as Trasylol, disclosed study data showing that it increased the risk of death, kidney damage, congestive heart failure and stroke.
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