Tranexamic Acid Is Safe in Patients with a History of Coronary Artery Disease Undergoing Total Joint Arthroplasty

• DOI: 10.2106/jbjs.20.01226
• Publication Date: 2021-05-13T15:01:47Z
• Authors: Stephen G. Zak; Alex Tang; Mohamad Sharan; Daniel Waren; Joshua C. Rozell; Ran Schwarzkopf
• Keywords: Post-hoc analysis

Tranexamic acid (TXA) is increasingly used to minimize blood loss during total joint arthroplasty (TJA). Although TXA has been shown be highly effective in reducing operative loss, many surgeons believe that it places patients with coronary artery disease (CAD) or a history of stents at an increased risk for myocardial infarction. The purpose this study was determine if safe use CAD stents.We performed retrospective analysis single, tertiary academic medical center identifying consecutive hip and knee cases over 8-year period. From cohort who received intraoperatively, we identified determined the infarction venous thromboembolism (VTE) rates within 90-day postoperative Chi-square analyses were identify differences VTE between cohorts. A post hoc power also whether our results powered detect difference rates.In 26,808 at-risk patients, there no infarctions. No significant observed compared control using either topical intravenous TXA, regard (0.29% 0.76%; p = 0.09) (0% 0.14). Moreover, when administration subcategorized into methods (0.13% 0.72%; 0.12) 0%; 1.0).In series, equally comparison cohort. With equal efficacy adverse events, recommend which may enable easier institutional implementation.Therapeutic Level III. See Instructions Authors complete description levels evidence.