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Aprotinin (Trasylol) Kidney Risk Linked to Off-Pump Bypass Plus ACE Inhibitors

February 8, 2008

BRISTOL, England, Feb. 8 (MedPage Today)— The risk of renal dysfunction after aprotinin (Trasylol) was used during heart surgery appears limited to patients also given ACE inhibitors during an off-pump bypass, suggested a retrospective analysis here.
Action Points

* Explain to interested patients that in heart surgery performed without the aid of a bypass pump, the concomitant use of ACE inhibitors and the blood-sparing drug aprotinin (Trasylol) appears to increase the risk of kidney dysfunction.

The risk of postoperative renal dysfunction almost tripled in patients receiving aprotinin and an ACE inhibitor during off-pump cardiac surgery, Kai Zacharowski, M.D., of the Bristol Royal Infirmary, and colleagues reported in the Feb. 9 issue of The Lancet.

Among patients having on-pump surgery, concomitant ACE inhibitor therapy did not increase renal risk with aprotinin. Worldwide marketing of the drug, intended to reduce allogeneic transfusions during bypass surgery, was suspended by Bayer last November.

“We recommend that it might be beneficial for patients to discontinue use of an ACE inhibitor before undergoing elective off-pump cardiac surgery, particularly patients with a history of renal impairment,” the authors concluded.

Continue reading, ‘Aprotinin (Trasylol) Kidney Risk Linked to Off-Pump Bypass Plus ACE Inhibitors’.