Tranexamic acid: less bleeding and less thrombosis?

被引：66

作者：

Godier, Anne ^{[1
,2
,3
]}

Roberts, Ian ^{[4
]}

Hunt, Beverley J. ^{[3
,5
,6
]}

机构：

[1] Paris Descartes Univ, Hotel Dieu Hosp, Dept Anesthesia & Crit Care, F-75004 Paris, France

[2] Paris Descartes Univ, Cochin Hosp, F-75004 Paris, France

[3] St Thomas Hosp, Rayne Inst, Dept Thrombosis & Vasc Biol, London SE1 7EH, England

[4] London Sch Hyg & Trop Med, Clin Trials Unit, London WC1E 7HT, England

[5] Guys & St Thomass NHS Fdn Trusts, Thrombosis & Haemostasis Ctr, London SE1 7EH, England

[6] Kings Coll London, London SE1 7EH, England

来源：

CRITICAL CARE | 2012年 / 16卷 / 03期

关键词：

MYOCARDIAL-INFARCTION; CONTROLLED-TRIAL; PLASMIN; ACTIVATION; MONOCYTES; SURGERY; INACTIVATION; PROTEOLYSIS; CLEAVAGE; RECEPTOR;

D O I：

10.1186/cc11374

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The early administration of tranexamic acid (TXA) to bleeding trauma patients reduces all-cause mortality without increasing the risk of vascular occlusive events. Indeed, the risk of arterial thrombosis appears to be reduced with TXA. In this commentary we hypothesize that TXA has an antithrombotic effect and explore potential mechanisms. These include inhibition of the inflammatory effects of plasmin, effects on platelets and effects on factors V and VIII. If proven, these antithrombotic effects would have major implications for the systemic use of TXA in surgical patients, where TXA has been clearly shown to reduce bleeding.

引用

页数：3

共 19 条

[1] Molecular Intercommunication between the Complement and Coagulation Systems [J].

Amara, Umme ;

Flierl, Michael A. ;

Rittirsch, Daniel ;

Klos, Andreas ;

Chen, Hui ;

Acker, Barbara ;

Brueckner, Uwe B. ;

Nilsson, Bo ;

Gebhard, Florian ;

Lambris, John D. ;

Huber-Lang, Markus .

JOURNAL OF IMMUNOLOGY, 2010, 185 (09) :5628-5636

[2] Acute coagulopathy of trauma: Hypoperfusion induces systemic anticoagulation and hyperfibrinolysis [J].

Brohi, Karim ;

Cohen, Mitchell J. ;

Ganter, Michael T. ;

Schultz, Marcus J. ;

Levi, Marcel ;

Mackersie, Robert C. ;

Pittet, Jean-Francois .

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2008, 64 (05) :1211-1217

[3] The serine protease plasmin triggers expression of MCP-1 and CD40 in human primary monocytes via activation of p38 MAPK and Janus kinase (JAK)/STAT signaling pathways [J].

Burysek, L ;

Syrovets, T ;

Simmet, T .

JOURNAL OF BIOLOGICAL CHEMISTRY, 2002, 277 (36) :33509-33517

[4] THROMBOLYSIS IN MYOCARDIAL-INFARCTION (TIMI) TRIAL, PHASE-I - A COMPARISON BETWEEN INTRAVENOUS TISSUE PLASMINOGEN-ACTIVATOR AND INTRAVENOUS STREPTOKINASE - CLINICAL FINDINGS THROUGH HOSPITAL DISCHARGE [J].

CHESEBRO, JH ;

KNATTERUD, G ;

ROBERTS, R ;

BORER, J ;

COHEN, LS ;

DALEN, J ;

DODGE, HT ;

FRANCIS, CK ;

HILLIS, D ;

LUDBROOK, P ;

MARKIS, JE ;

MUELLER, H ;

PASSAMANI, ER ;

POWERS, ER ;

RAO, AK ;

ROBERTSON, T ;

ROSS, A ;

RYAN, TJ ;

SOBEL, BE ;

WILLERSON, J ;

WILLIAMS, DO ;

ZARET, BL ;

BRAUNWALD, E .

CIRCULATION, 1987, 76 (01) :142-154

[5] Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk [J].

Devereaux, PJ ;

Goldman, L ;

Cook, DJ ;

Gilbert, K ;

Leslie, K ;

Guyatt, GH .

CANADIAN MEDICAL ASSOCIATION JOURNAL, 2005, 173 (06) :627-634

[6] Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial [J].

Jimenez, Juan J. ;

Iribarren, Jose L. ;

Lorente, Leonardo ;

Rodriguez, Jose M. ;

Hernandez, Domingo ;

Nassar, Ibrahim ;

Perez, Rosalia ;

Brouard, Maitane ;

Milena, Antonio ;

Martinez, Rafael ;

Mora, Maria L. .

CRITICAL CARE, 2007, 11 (06)

[7] Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis [J].

Ker, Katharine ;

Edwards, Phil ;

Perel, Pablo ;

Shakur, Haleema ;

Roberts, Ian .

BMJ-BRITISH MEDICAL JOURNAL, 2012, 344

[8] Identification of the annexin A2 heterotetramer as a receptor for the plasmin-induced signaling in human peripheral monocytes [J].

Laumonnier, Y ;

Syrovets, T ;

Burysek, L ;

Simmet, T .

BLOOD, 2006, 107 (08) :3342-3349

[9]

LEE CD, 1989, BLOOD, V73, P185

[10] Proteolysis of tissue factor pathway inhibitor (TFPI) by plasmin: Effect on TFPI activity [J].

Li, A ;

Wun, TC .

THROMBOSIS AND HAEMOSTASIS, 1998, 80 (03) :423-427

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