Aspirin and tranexamic acid for coronary artery surgery trial

• Research type

  Research Study

• Full title

  The ATACAS Trial: Aspirin and Tranexamic Acid for Coronary Artery Surgery Trial

• IRAS ID

  28150

• Contact name

  Mohandas J Jayarajah

• Sponsor organisation

  Plymouth Hospitals NHS Trust

• Eudract number

  2009-015013-46

• ISRCTN Number

  N/A

• Research summary

  There are some compelling reasons to question the current routine stopping of aspirin before elective coronary artery bypass graft (CABG) surgery. Although aspirin may increase bleeding, it may also reduce heart attacks, other serious complications and death. Tranexamic Acid (TA) can counteract possible bleeding complications of aspirin in CABG patients, and are likely to have additional benefits. There is no evidence that the effects of TA are significantly different to similar agents such as aminocaproic acid or Aprotinin. On the basis of cost and safety, the best agent to evaluate is TA. Large outcome trial data are lacking. When considering the cost and extent of CABG surgery in Australia (n>18,000) and around the world, small differences in outcome would have major implications for the management of the bleeding tendency following CABG surgery, the continuation of aspirin up to the day of surgery and potential reduction in costs. We propose a large randomised trial to answer two clinically important questions:i.Should low-dose aspirin be continued up until the day of CABG surgery?ii.Should TA be used for all at-risk CABG surgery?

• REC name

  South West - Cornwall & Plymouth Research Ethics Committee

• REC reference

  09/H0206/44

• Date of REC Opinion

  3 Dec 2009

• REC opinion

  Further Information Favourable Opinion