Article Text

Download PDFPDF
Scientific letter: Could tranexamic acid use in surgery reduce perioperative myocardial infarction?
  1. Ian Roberts
  1. Correspondence to Dr Ian Roberts, Clinical Trials Unit, LSHTM, London School of Hygiene & Tropical Medicine, London, UK; Ian.Roberts{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

To the Editor Endogenous plasmin produced during trauma and surgery reduces clot stability and worsens bleeding. Plasmin production can be inhibited with tranexamic acid, a competitive antagonist of the lysine binding sites on plasminogen. Although caution is urged in patients at high risk of arterial occlusive events, due to the possibility that tranexamic acid might precipitate myocardial infarction, results from clinical trials show that tranexamic acid decreases rather than increases the risk of myocardial infarction.

The clinical randomisation of antifibrinolytic in significant haemorrhage 2 (CRASH-2) trial was a multicentre randomised controlled trial of early (within 8 h of injury) administration of tranexamic acid (1 g intravenous, loading dose followed by 1 g infusion over 8 h) or placebo in 20 211 patients with traumatic bleeding. Tranexamic acid …

View Full Text


  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.