Research: Blood thinner reduces risk after heart damage in surgery

By Allen Cone

March 12 (UPI) -- A blood-thinning drug significantly reduces the risk of complications from a heart injury after major non-cardiac surgery, report researchers in Canada.

Researchers found dabigatran was effective in the first randomized controlled study to evaluate ways to reduce such heart injuries, according to study results presented last week at the American College of Cardiology's annual conference in Orlando last week. Dabigatran is sold under the brand name Pradaxa, which is made by Boehringer Ingelheim, a drugmaker that helped fund the study.


The study was conducted by the Population Health Research Institute of McMaster University and Hamilton Health Sciences in Ontario, Canada.

"We now have an option for improving outcomes for a large population of people who have a heart injury after surgery each year," Dr. P.J. Devereaux, a professor at McMaster, said in a press release.

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Previous research suggests about 8 percent of adults undergoing major non-cardiac surgery, roughly eight million people, will develop a myocardial injury, called MINS. The condition occurs because the tissue of the heart is damaged in response to the stress of surgery on the body -- which causes death in approximately 10 percent of patients who experience it within 30 days.


MINS can affect patients who undergo hip or knee replacement, bowel resection, or abdominal aortic aneurysm repair, among other major surgical procedures, which can then lead to severe complications, including heart attack, stroke, blood clots, amputations and death.

"This is an important issue that affects thousands of people around the world," Devereaux said. "This discovery marks an important step in the journey to improve outcomes for patients who suffer MINS after surgery."

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The study included 1,754 participants in 19 countries who are an average age of 70 years old. Following 16 months of follow-up, the researchers found just 11 percent of patients treated with dabigatran had a major complication, compared to 15 percent of those given a placebo -- a 28 percent drop in risk.

While many blood-thinning medications carry a risk of bleeding, researchers reported no significant difference between the two groups in terms of life-threatening, major or critical organ bleeding.

"Patients with evidence of even mild damage to the heart after surgery are at high risk of adverse events in the long term," said Salim Yusuf, chairman of the Manage trial and executive director of PHRI. "It appears that this risk can be mitigated by antithrombotic therapy. Future studies can explore additional ways to reduce these risks."


Last year, Devereaux and his colleagues found that a simple blood test could identify patients with MINS after surgery. Then, clinicians could take action before complications occurred.

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