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Meta-Analysis of Placebo-Controlled Trials of Aprotinin Assessing the Relative Risk of Reoperations in Patients Undergoing Coronary Artery Bypass Graft Surgery

机译：Meta-Analysis of Placebo-Controlled Trials of Aprotinin Assessing the Relative Risk of Reoperations in Patients Undergoing Coronary Artery Bypass Graft Surgery

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Objective and MethodsA meta-analysis of phase II and III randomised, placebo-controlled trials of full-dosage aprotinin (2 million KIU loading dose followed by 0.5 million KIU/h and 2 million KIU into pump prime volume) was undertaken to determine whether this drug reduces the incidence of reoperations.PatientsA total of 1818 aprotinin and 1808 placebo recipients undergoing coronary artery bypass graft surgery were available for analysis from 33 studies.ResultsThe relative risk of reoperations in the aprotinin group relative to the placebo group was 0.51 (95 CI: 0.37, 0.72). The proportions of patients requiring reoperations for surgical (2.0vs3.6) or diffuse (0.2vs1.4) bleeding were also lower for aprotinin recipients than placebo recipients.ConclusionThese results suggest a strong treatment effect in favour of full-dosage aprotinin in reducing the incidence of reoperations, and suggest that aprotinin offers patients a relevant degree of protection against reoperation-associated morbidity and mortality.

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