{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T04:06:23Z","timestamp":1754107583774},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2023,4]]},"abstract":"Abstract<\/jats:title>\n Background\u2003In valvular open-heart surgery, data regarding the effect of a moderate dose of tranexamic acid (TXA) on clinical outcomes are limited.<\/jats:p>\n Methods\u2003Out of a cohort of 13,293 patients, we performed a propensity-score-matched analysis in 6,106 patients and assessed the risk of convulsive seizures (CS, primary endpoint), stroke, renal replacement therapy, and mortality (secondary endpoints). In the entire study cohort of 13,293 patients, we also assessed the multivariable-adjusted association of CS with postoperative outcomes.<\/jats:p>\n Results\u2003The risk of CS was significantly higher in the TXA group (2.4%; n\u2009=\u200972) than in the non-TXA group (1.0%; n\u2009=\u200932), with a relative risk ratio (RR) of 2.28 (95% confidence interval [CI]: 1.50\u20133.47; p\u2009<\u20090.001). The risk of CS was also higher in patients receiving TXA doses \u226525\u2009mg\/kg body weight (3.7%; n\u2009=\u200940) than in patients receiving <25\u2009mg\/kg body weight (1.6%; n\u2009=\u200932; p\u2009<\u20090.001). Perioperative secondary clinical endpoints and 1-year mortality did not differ significantly between study groups (p-value\u2009>\u20090.05). Compared with non-CS patients (n\u2009=\u200913,000), patients with nonhemorrhagic, nonembolic CS (n\u2009=\u2009253) revealed higher multivariable-adjusted in-hospital risks of stroke (RR: 3.82 [95% CI: 2.44\u20135.60; p\u2009<\u20090.001]) and mortality (RR: 2.07 [95% CI: 1.23\u20133.48; p\u2009=\u20090.006]), and a higher 1-year mortality risk (RR: 1.85 [95% CI: 1.42\u20132.41; p\u2009<\u20090.001]).<\/jats:p>\n Conclusion\u2003A moderate TXA dose was associated with a significantly higher risk of seizure, but not with other clinical complications such as stroke, renal replacement therapy, and mortality. However, in the small group of patients experiencing a seizure, the risks of stroke and short- and mid-term mortality were substantially higher than in patients not experiencing a seizure, indicating that the use of a low-dose TXA protocol (<25\u2009mg\/kg body weight) should be considered.<\/jats:p>","DOI":"10.1055\/s-0041-1724035","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T23:43:11Z","timestamp":1614901391000},"page":"181-188","source":"Crossref","is-referenced-by-count":5,"title":["Moderate Dose of Tranexamic Acid and Complications after Valvular Heart Surgery"],"prefix":"10.1055","volume":"71","author":[{"given":"Nikolai","family":"Hulde","sequence":"additional","affiliation":[{"name":"Institute of Anesthesiology and Pain Therapy, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Zittermann","sequence":"additional","affiliation":[{"name":"Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus-Andre","family":"Deutsch","sequence":"additional","affiliation":[{"name":"Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"von Dossow","sequence":"additional","affiliation":[{"name":"Institute of Anesthesiology and Pain Therapy, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan E.","family":"Gummert","sequence":"additional","affiliation":[{"name":"Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Koster","sequence":"additional","affiliation":[{"name":"Institute of Anesthesiology and Pain Therapy, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1186\/s12871-019-0772-0","article-title":"Different dose regimes and administration methods of tranexamic acid in cardiac surgery: a meta-analysis of randomized trials","volume":"19","author":"J Guo","year":"2019","journal-title":"BMC Anesthesiol"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1002\/ana.24558","article-title":"Tranexamic acid-associated seizures: causes and 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A systematic review of pharmacodynamics studies","volume":"30","author":"R Picetti","year":"2019","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1093\/bja\/aet255","article-title":"Population pharmacokinetics of tranexamic acid in adults undergoing cardiac surgery with cardiopulmonary bypass","volume":"111","author":"S Grassin-Delyle","year":"2013","journal-title":"Br J Anaesth"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/icvts\/ivz316","article-title":"Tranexamic acid and convulsive seizures after isolated coronary artery bypass surgery: the role of cardiopulmonary bypass and renal function","volume":"30","author":"N Hulde","year":"2020","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.athoracsur.2015.02.077","article-title":"Nonischemic postoperative seizure does not increase mortality after cardiac surgery","volume":"100","author":"N S Ivascu","year":"2015","journal-title":"Ann Thorac Surg"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.jtcvs.2018.09.113","article-title":"Tranexamic acid in coronary artery surgery: one-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial","volume":"157","author":"P S Myles","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1345\/aph.1L307","article-title":"Cephalosporin-induced neurotoxicity: clinical manifestations, potential pathogenic mechanisms, and the role of electroencephalographic monitoring","volume":"42","author":"M F Grill","year":"2008","journal-title":"Ann Pharmacother"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1724035.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T23:30:35Z","timestamp":1680737435000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1724035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,4]]},"references-count":14,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,4,5]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1724035","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,4]]}}}