TXA Is Safe in Patients with a History of Coronary Artery Disease Undergoing TJA
TXA Is Safe in Patients with a History of Coronary Artery Disease Undergoing TJA
TXA Is Safe in Patients with a History of Coronary Artery Disease Undergoing TJA
Stephen G. Zak, BA
doi:10.2106/JBJS.20.01226
Content
6.72 -> hello everyone my name is ryan
8.08 -> schwarzkopf
8.88 -> i'm a professor of orthopedics here at
10.559 -> nyu langone health and i'll be speaking
13.28 -> today about our jbjs
14.92 -> article named transamic acid is safe in
17.84 -> patients with a history of coronary
19.279 -> artery disease
20.08 -> undergoing tall joint arthroplasty a
22.56 -> little bit of a background
23.6 -> transdemic acid has been shown to be a
25.279 -> highly effective meadow
26.72 -> for reducing blood loss and the risk of
28.56 -> transfusion for total
30.16 -> and arthroplasty however many patients
32.48 -> with coronary artery disease and
34.239 -> coronary stents
35.44 -> have been excluded uh from receiving
37.6 -> transcendentic acid
38.8 -> due to fears of cardiac and trobotic
40.879 -> events
41.84 -> at our institution like in many others
43.76 -> anesthesiologists and surgeons sometimes
45.84 -> opt to administer
47.12 -> txa in select cases of this patient
49.52 -> cohort
50.719 -> we therefore wanted to determine if txa
53.12 -> was a safe and effective method for
54.64 -> blood loss management
55.92 -> in the patient court who is otherwise
57.6 -> thought to have a contraindication or a
59.68 -> relative contraindication
61.199 -> for administration of txa while we found
64.08 -> that patients with coronary artery
65.439 -> disease or cardiac stents were not
67.52 -> at increased risk of vte in comparison
69.84 -> to our institutional rates
71.76 -> due to the use of txa it was surprising
74.24 -> to discover
74.96 -> through a sub-analysis that the method
77.04 -> of administration did not affect vt
79.04 -> rates as well
80 -> although the sub-analysis was not fully
82 -> powered these findings set an
83.759 -> interesting precedent for future studies
86.08 -> about the systemic effect of different
87.92 -> txa administration methods
90.56 -> txa has played a key role in preventing
92.64 -> blood loss in toe joint arthroplasty
95.04 -> but many surgeons and anesthesiologists
96.96 -> are hesitant about its use in patients
99.04 -> with coronary artery disease and
100.4 -> coronary stents
101.759 -> due to fears of vt events our results
104.479 -> should help to ease some of these fears
106.24 -> especially if the only contraindication
108.079 -> is a history of coronary artery disease
110.079 -> or coronary stents more than six months
112.799 -> prior surgery
114 -> patients with these contraindications
115.68 -> should not necessarily be excluded from
117.28 -> benefiting clinically from its use
119.6 -> and the benefits that txa gave for blood
121.68 -> loss however our results are from a
123.52 -> retrospective cohort study
125.36 -> and therefore recommend future and
127.6 -> further research
128.72 -> on prospective trials to confirm the
130.8 -> safety and efficacy of txa use in
133.04 -> patients with coronary artery disease
134.879 -> and coronary stents as well as to
137.36 -> determine the safest administration
139.04 -> method
139.599 -> however the study lays the groundwork
141.44 -> for future studies of a patient
143.2 -> population who has traditionally been
144.879 -> removed from
146.319 -> txa treatment and hopefully these
149.92 -> patients can clinically benefit in the
151.519 -> future
152.08 -> from these blood management methods i
155.04 -> thank everyone and i hope you enjoyed
156.8 -> the article
Source: https://www.youtube.com/watch?v=t7ownbTTRac