Comparison of two doses of aprotinin in patients receiving aspirin before coronary bypass surgery

This study was designed to evaluate efficacy and tolerability of two differ ent doses of aprotinin in patients receiving aspirin before undergoing coro nary artery bypass grafting. Forty-two patients were randomized to receive either placebo (group I), or aprotinin in doses of 4 000 000 KIU (group II) or 6 000 000 KIU (group III). Drug efficacy was determined by measuring po stoperative blood loss and transfusion of blood products. Both doses were e ffective in reducing blood loss and transfusion requirements. Blood loss th rough thoracotomy drainage was 450 +/- 224, 182 +/- 144, 142 +/- 98 mi, res pectively, for control and treatment groups II and III (p = 0.0001). The nu mbers of patients with blood transfusions were seven (50%), two (17%) and t wo (17%) for group I and treatment groups II and ill, respectively (p = 0.1 0). Tolerability was excellent and complications few and reversible. In conclusion, high and medium doses of aprotinin were well tolerated and r educed bleeding and transfusion requirements in patients submitted to coron ary bypass surgery under the effects of aspirin.