https://doi.org/10.55788/d3a880c3
Prof. Philip Devereaux (McMaster University, Canada) presented the international, multicentre, randomised POISE-3 study (NCT03505723) during the late-breaking session for high-impact publications in critical care, as the results were just recently published in the New England Journal of Medicine [1,2]. POISE-3 randomised 9,535 patients undergoing non-cardiac surgery 1:1 to receive either 1 g intravenous bolus of tranexamic acid or placebo at the start and end of surgery [1]. The primary efficacy endpoint for the evaluation of tranexamic acid was a composite bleeding outcome comprising life-threatening bleeding, major bleeding, or bleeding into a critical organ at 30 days. The primary cardiovascular safety endpoint was a composite cardiovascular outcome, comprising myocardial injury after non-cardiac surgery, non-haemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism at 30 days.
After 1 month, a composite bleeding event occurred in 9.1% in the tranexamic acid group and 11.7% in the placebo group (HR 0.76; 95% CI 0.67–0.87; P<0.001). Additionally, there was no difference in the safety composite cardiovascular endpoint: events occurred in 14.2% of the tranexamic acid arm and 13.9% of the placebo group (HR 1.02; 95% CI 0.92–1.14; Pnon-inferiority=0.04).
Prof. Devereaux concluded that among patients undergoing non-cardiac surgery, the incidence of the composite bleeding outcome was significantly lower with tranexamic acid than with placebo, with no significant safety burden associated with this treatment.
- Devereaux PJ, et al. Efficacy And Safety Of Tranexamic Acid In Patients Undergoing Noncardiac Surgery: The Poise-3 Trial. Session A84, ATS International Conference 2022, San Francisco, CA, USA, 13–18 May.
- Devereaux PJ, et al. N Engl J Med 2022; Apr 02. DOI: 10.1056/NEJMoa2201171.
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