Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) Trial: Rationale and design

被引：46

作者：

Myles, Paul S. ^{[1
,2
,3
,4
]}

Smith, Julian ^{[5
,6
]}

Knight, John ^{[7
]}

Cooper, James ^{[3
,8
]}

Silbert, Brendan ^{[9
,10
,12
]}

McNeil, John ^{[3
]}

Esmore, Donald S. ^{[6
]}

Buxton, Brian ^{[11
]}

Krum, Henry ^{[3
,4
]}

Forbes, Andrew ^{[3
,13
]}

Tonkin, Andrew ^{[3
,4
]}

机构：

[1] Alfred Hosp, Dept Anaesthesia & Perioperat Med, Melbourne, Vic 3004, Australia

[2] Monash Univ, Academ Board Anaesthesia & Perioperat Med, Melbourne, Vic 3004, Australia

[3] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia

[4] Australian Natl Hlth & Med Res Council, Ctr Clin Res Excellence Therapeut, Melbourne, Vic, Australia

[5] Monash Med Ctr, Cardiovasc Surg Unit, Melbourne, Vic, Australia

[6] Monash Med Ctr, Dept Surg, Melbourne, Vic, Australia

[7] Flinders Med Ctr, Dept Cardiac Serv, Adelaide, SA, Australia

[8] Alfred Hosp, Dept Intens Care, Melbourne, Vic, Australia

[9] St Vincents Hosp, Dept Anaesthesia, Melbourne, Vic, Australia

[10] Univ Melbourne, Dept Surg, Melbourne, Vic, Australia

[11] Austin Hosp, Dept Cardiothorac Surg, Heidelberg, Vic 3084, Australia

[12] Alfred Hosp, Dept Cardiothorac Surg, Melbourne, Vic, Australia

[13] Monash Univ, Biostat Unit, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia

来源：

AMERICAN HEART JOURNAL | 2008年 / 155卷 / 02期

基金：

英国医学研究理事会;

关键词：

D O I：

10.1016/j.ahj.2007.10.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Despite some concern that recent aspirin ingestion increases blood loss after coronary artery surgery, there is some evidence that this may reduce thrombotic complications. In contrast, antifibrinolytic drugs can reduce blood loss in this setting, but there is concern that they may increase thrombotic complications. Published guidelines are limited by a lack of large randomized trials addressing the risks and benefits of each of these commonly used therapies in cardiac surgery. The ATACAS Trial is a study comparing aspirin, tranexamic acid, or both, with placebo in patients undergoing on-pump or off-pump coronary artery surgery. Methods We discuss the rationale for conducting ATACAS, a 4600-patient, multicenter randomized trial in at-risk coronary artery surgery, and the features of the ATACAS study design (objectives, end points, target population, allocation, treatments, patient follow-up, and analysis). Conclusions The ATACAS Trial will be the largest study yet conducted to ascertain the benefits and risks of aspirin and antifibrinolytic therapy in coronary artery surgery. Results of the trial will guide the routine clinical care of patients in this setting.

引用

页码：224 / 230

页数：7

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