Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (1): 65-70.doi: 10.24920/003596
• Original Article • Previous Articles Next Articles
Yao Yuntai1, *(), Yuan Xin2, Shao Ken1, 3
Published:
2020-03-31
Online:
2020-01-20
Contact:
Yao Yuntai
E-mail:yuntaiyao@126.com
Yao Yuntai, Yuan Xin, Shao Ken. Acute Myocardial Infarction After Tranexamic Acid: Review of Published Case Reports[J].Chinese Medical Sciences Journal, 2020, 35(1): 65-70.
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Table 1
Clinical characteristics of the included case reports"
References | Country | Sex | Age (yrs) | Risk factors of thrombosis | Past history | TXA and co-medications |
---|---|---|---|---|---|---|
Gerstein et al.[ | USA | M | 66 | deep vein thrombosis, transit ischemia attack, HIV(+) | COPD, spine surgeries | TXA (1 g iv. followed by 1 mg/kg·h infusion) during spine surgery |
Garg et al.[ | USA | F | 56 | hypertension, obesity, smoking | arthritis | TXA (10 mg/kg iv.) before hip anthroplasty |
Gupta et al.[ | India | F | 41 | hypertension | menorrhagia, dysmenorrhoea, uterus fibroid | TXA (0.5 g po tid ×2 year)+mefenamic acid (0.25 g po tid ×2 year) for menorrhagia and dysmenorrhoea |
Günaldi et al.[ | Turkey | M | 49 | hemophilia A, factor V Leiden mutation, smoking | intra-articular hemorrhage | TXA (20 mg/kg po. qd ×10 days) and r-FⅧ (40 U/kg iv.) before tooth extraction |
Sirker et al.[ | UK | F | 28 | hyperlipidemia, contraceptive | bleeding diathesis, nose bleeding | TXA (1 g qd ×1 week) and DDAVP iv. after and before shoulder surgery, respectively |
Iacobellis et al.[ | Italy | F | 42 | contraceptive | uterine leiomyoma | TXA (3 g im. qd) and contraceptive pill (ethinylestradiol 20 μg and gestodene 75 μg) ×2 months for menorrhagia |
Mekontso-Dessap et al.[ | France | F | 77 | hypertension | tuberculosis | TXA (0.5 g po. bid ×5 day then 1.0 g po bid ×2 days) for haemoptysis related to pulmonary tuberculosis |
Table 2
Diagnosis of myocardial infarction of the included case reports"
References | Onset | Manifestations | ECG | Enzymes | CA angiography | Diagnosis |
---|---|---|---|---|---|---|
Gerstein et al.[ | in PACU | tachycardia | ST elevation (anterior, anterolateral leads) | TnI 4.04 ng/ml | proximal LAD lesion, complete occlusion of diagonal branch | MI, LV thrombus |
Garg et al.[ | postoperatively | chest pain, diaphoresis, hypotension | ST elevation (leads Ⅱ, Ⅲ, aVF) | TnI 0.25 ng/ml and CK 427 U/L | complete occlusion of the distal RCA | MI (inferior wall) |
Gupta et al.[ | fourteen days from last time of TXA | chest pain, sweating | ST elevation (inferior wall and RV) | Not reported | RCA: eccentric 99% lesion of proximal RCA with thrombus | MI (inferior wall, RV) |
Günaldi et al.[ | after r-FⅧ administration | chest pain, agitation, sweating | ST elevation (leads Ⅲ, Ⅱ, aVF, V4) and ST depression (leads V1, V2) | LDH 392U/L and CK-MB 170 U/L | RCA 90% stenosis, LAD 40% stenosis | MI (inferoposterolateral wall, RV) |
Sirker et al.[ | three days after therapy | chest pain | ST elevation (inferior) | elevated in keeping with the acute occlusion | Occlusion in a small distal branch of RCA, minimal wall irregularity of LAD | MI (inferior wall) |
Iacobellis et al.[ | two months after TXA and contraceptive | chest pain | deep negative T waves and Q wave in leads V1 to V4 | TnI 4.3 μg/ml, CK-MB 66 ng/ml, and CK 653 U/L | Ulcerated plaque on proximal LAD without narrowing | MI |
Mekontso-Dessap et al.[ | two days after dosage doubling | chest pain | ECG resolved quickly | TnI 5 μg/ml | Middle portion of LAD focal stenosis 30% | MI |
Appendix.
Database search strategies"
Search strategies | Results |
---|---|
MEDLINE (“tranexamic acid”[MeSH Terms] OR (“tranexamic”[All Fields] AND “acid”[All Fields]) OR “tranexamic acid”[All Fields]) AND ((“myocardial ischaemia”[All Fields] OR “myocardial ischemia”[MeSH Terms] OR (“myocardial”[All Fields] AND “ischemia”[All Fields]) OR “myocardial ischemia”[All Fields] OR “coronary artery disease”[MeSH Terms] OR (“coronary”[All Fields] AND “artery”[All Fields] AND “disease”[All Fields]) OR “coronary artery disease”[All Fields] OR (“myocardial”[All Fields] AND “ischemia”[All Fields])) OR (“myocardial infarction”[MeSH Terms] OR (“myocardial”[All Fields] AND “infarction”[All Fields]) OR “myocardial infarction”[All Fields]) OR ((“myocardium”[MeSH Terms] OR “myocardium”[All Fields] OR “myocardial”[All Fields]) AND (“wounds and injuries”[MeSH Terms] OR (“wounds”[All Fields] AND “injuries”[All Fields]) OR “wounds and injuries”[All Fields] OR “injury”[All Fields])) OR (“troponin”[MeSH Terms] OR “troponin”[All Fields]) OR (“creatine kinase”[MeSH Terms] OR (“creatine”[All Fields] AND “kinase”[All Fields]) OR “creatine kinase”[All Fields]) OR (“l-lactate dehydrogenase”[MeSH Terms] OR (“l-lactate”[All Fields] AND “dehydrogenase”[All Fields]) OR “l-lactate dehydrogenase”[All Fields] OR (“lactate”[All Fields] AND “dehydrogenase”[All Fields]) OR “lactate dehydrogenase”[All Fields]) OR (“electrocardiography”[MeSH Terms] OR “electrocardiography”[All Fields] OR “electrocardiograph”[All Fields])) AND (“humans”[MeSH Terms] AND English[lang]) | 7/120 |
OVID ((Tranexamic acid AND myocardial ischemia).mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) OR ((Tranexamic acid AND myocardial infarction).mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) OR ((Tranexamic acid AND myocardial injury).mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) OR ((Tranexamic acid AND troponin).mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) OR ((Tranexamic acid AND creatine kinase).mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) OR ((Tranexamic acid AND lactate dehydrogenase).mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) OR ((Tranexamic acid AND Electrocardiograph.mp.[mp=ti, ab, tx, kw, ct, ot, sh, hw]) | 0/100 |
Cochrane ((“Tranexamic acid”):ti, ab, kw (Word variations have been searched) AND ((“myocardial ischemia”): ti, ab, kw (Word variations have been searched) OR (“myocardial infarction”): ti, ab, kw (Word variations have been searched) OR (“myocardial injury”): ti, ab, kw (Word variations have been searched) OR (“troponin”): ti, ab, kw (Word variations have been searched) OR (“creatine kinase”): ti, ab, kw (Word variations have been searched) OR (“lactate dehydrogenase”): ti, ab, kw (Word variations have been searched) OR (“Electrocardiograph”): ti, ab, kw (Word variations have been searched)) | 0/123 |
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