Tranexamic acid use may not increase thrombotic events in high-risk patients
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Key takeaways:
- Tranexamic acid utilization did not increase the risk for thrombotic events in high-risk patients.
- Tranexamic acid was associated with lower rates of anemia and allogenic transfusion.
Results published in The Journal of Bone & Joint Surgery showed the use of tranexamic acid during total joint arthroplasty did not increase the risk for thrombotic complications in patients with a history of venous thromboembolism.
“Moreover, patients who received tranexamic acid had expectedly lower rates of anemia and lower rates of allogenic transfusion,” Nathanael D. Heckmann, MD, assistant professor in the department of orthopedic surgery at Keck Medicine of University of Southern California, told Healio. “While surgeons should be reassured with these data, they should note that this is a high-risk patient population at increased risk of deep venous thrombosis and pulmonary embolism regardless of whether or not they receive tranexamic acid.”
Heckmann and colleagues categorized 70,759 patients with a history of venous thromboembolism from the Premier Healthcare Database who underwent primary total knee or total hip arthroplasty between 2015 and 2021 based on whether they received tranexamic acid (n = 46,074) or not (n = 24,685). Outcome measures included the risk for 90-day thromboembolic complications, bleeding-related complications, infectious complications, wound complications, medical complications and hospital readmission.
Researchers found patients who received tranexamic acid had comparable rates of pulmonary embolism and deep vein thrombosis compared with those who did not receive tranexamic acid. Patients who received tranexamic acid also had decreased rates of bleeding-related complications and medical complications compared with those who did not receive tranexamic acid.
In addition, researchers found patients who received tranexamic acid had a significantly shorter length of stay and reduced risk for 90-day readmission after TJA.
“We were surprised with these findings,” Heckmann said. “We thought we may identify small but clinically relevant increases in the risk of rare complications such as stroke and pulmonary embolism.”
He concluded, “We are currently investigating other potential benefits and side-effects of tranexamic acid utilization.”
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