Aprotinin causes no increased risk of organ dysfuntion in coronary artery bypass procedures

Objectives: Continuing controversy exists regarding the use of aprotinin during cardiac surgery, especially with regard to mortality, postoperative myocardial infarction, cerebral infarction and renal dysfunction. In order to find out if the use of aprotinin causes an increased risk of organ dysfunction in patients undergoing coronary surgery at our hospital we compared patients receiving aprotinin with a control group without use of aprotinin.

Methods: 852 patients were included in the retrospective study. Aprotinin was used in 518 patients (study group), while 334 patients were included in the control group.

Results: Mortality was 2.1% in the study and 4.1% in the control group (p=0.096). A perioperative myocardial infarction was observed in 1.5% in the study group while the incidence was 1.8% in the control group (p=0.78). Regarding cerebral infarction there was no significant difference between both groups (study: 1.1% versus control: 1.5% p=0.93). The same was true considering postoperative renal dysfunction (study: 2.5% versus control: 4.2% p=0.23).

Conclusion: Aprotinin causes no increased risk of organ dysfunction in patients undergoing coronary surgery at our hospital. The conflicting results regarding the adverse effects of aprotinin in cardiac surgery may be due to different perioperative management.