Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (1): 65-70.doi: 10.24920/003596

• 论著 • 上一篇    下一篇

氨甲环酸相关的急性心肌梗死:已发表病例回顾

姚允泰1,*(),袁昕2,邵恳1,3   

  1. 1中国医学科学院 北京协和医学院,国家心血管病中心 阜外医院麻醉科,北京 100037
    2中国医学科学院 北京协和医学院,国家心血管病中心 成人心脏外科,北京 100037
    3湖北省荆门市第一人民医院麻醉科,荆门,湖北 448000
  • 出版日期:2020-03-31 发布日期:2020-01-20
  • 通讯作者: 姚允泰 E-mail:yuntaiyao@126.com

Acute Myocardial Infarction After Tranexamic Acid: Review of Published Case Reports

Yao Yuntai1,*(),Yuan Xin2,Shao Ken1,3   

  1. 1Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
    2Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
    3Department of Anesthesiology, Jingmen No. 1 People’s Hospital, Jingmen, Hubei 448000, China
  • Published:2020-03-31 Online:2020-01-20
  • Contact: Yao Yuntai E-mail:yuntaiyao@126.com

摘要:

目的 总结已发表的氨甲环酸(TXA)相关的急性心肌梗死(AMI)病例。
方法 我们在电子数据库中检索已发表的TXA治疗后的AMI病例,并分别提取入选病例的相关数据,包括患者AMI的临床表现、辅助检查、药物治疗史、AMI治疗结果及预后。
结果 最终检索出7篇已发表的TXA治疗后的AMI病例报道(共7例患者),其中2篇来自美国,其余5篇分别来自印度、土耳其、英国、意大利和法国。7例患者中,年龄最轻者28岁,最长者77岁,5例为女性,2例为男性。4人接受TXA治疗系因外科出血、2例因月经出血、1例因咯血。7例患者AMI的诊断基于症状、ECG表现、心肌酶及冠状动脉造影。4例患者在确诊后接受了冠状动脉支架植入术、抗血小板及抗凝治疗等。在住院及随访期内,无死亡病例,7例均未发生其他重大的心血管事件。
结论 本文提示TXA与AMI可能相关。即便是栓塞低风险的患者,这种风险也值得重视。

关键词: 氨甲环酸, 血栓形成, 心肌梗死

Abstract:

Objective To summarize cases of acute myocardial infarction (AMI) after tranexamic acid (TXA) administration.
Methods Electronic databases were searched to identify all case reports presenting AMI after use of TXA. Two authors independently extracted data of patients’ manifestation, examinations, medical history, treatment and outcome.
Results Our search yielded seven case reports including seven patients. Among the seven reports, two were from USA, and the other five were from India, Turkey, UK, Italy and France, respectively. Of the seven patients aged between 28- and 77-year-old who developed AMI after TXA, five patients were female and two were male. TXA was prescribed for four patients to reduce surgical bleeding, for two patients to treat menorrhagia and for one patient to manage hemoptysis. The diagnosis of AMI was made based upon patients’ symptoms, ECG, myocardium-specific enzymes, and confirmed by coronary angiography. Coronary stents were placed in four patients, for whom anti-platelet and anti-coagulation drugs were prescribed. No death or major cardiovascular events were reported during hospitalization and follow-up.
Conclusion These case reports suggested a possible association of TXA administration and an increased risk of AMI, even in patients with relatively low thrombotic risk.

Key words: tranexamic acid, thrombosis, myocardial infarction

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