TY - JOUR
T1 - The many roles of tranexamic acid
T2 - An overview of the clinical indications for TXA in medical and surgical patients
AU - Cai, Johnny
AU - Ribkoff, Jessica
AU - Olson, Sven
AU - Raghunathan, Vikram
AU - Al-Samkari, Hanny
AU - DeLoughery, Thomas G.
AU - Shatzel, Joseph J.
N1 - Publisher Copyright:
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Clinically significant bleeding can occur as a consequence of surgery, trauma, obstetric complications, anticoagulation, and a wide variety of disorders of hemostasis. As the causes of bleeding are diverse and not always immediately apparent, the availability of a safe, effective, and non-specific hemostatic agent is vital in a wide range of clinical settings, with antifibrinolytic agents often utilized for this purpose. Tranexamic acid (TXA) is one of the most commonly used and widely researched antifibrinolytic agents; its role in postpartum hemorrhage, menorrhagia, trauma-associated hemorrhage, and surgical bleeding has been well defined. However, the utility of TXA goes beyond these common indications, with accumulating data suggesting its ability to reduce bleeding and improve clinical outcomes in the face of many different hemostatic challenges, without a clear increase in thrombotic risk. Herein, we review the literature and provide practical suggestions for clinical use of TXA across a broad spectrum of bleeding disorders.
AB - Clinically significant bleeding can occur as a consequence of surgery, trauma, obstetric complications, anticoagulation, and a wide variety of disorders of hemostasis. As the causes of bleeding are diverse and not always immediately apparent, the availability of a safe, effective, and non-specific hemostatic agent is vital in a wide range of clinical settings, with antifibrinolytic agents often utilized for this purpose. Tranexamic acid (TXA) is one of the most commonly used and widely researched antifibrinolytic agents; its role in postpartum hemorrhage, menorrhagia, trauma-associated hemorrhage, and surgical bleeding has been well defined. However, the utility of TXA goes beyond these common indications, with accumulating data suggesting its ability to reduce bleeding and improve clinical outcomes in the face of many different hemostatic challenges, without a clear increase in thrombotic risk. Herein, we review the literature and provide practical suggestions for clinical use of TXA across a broad spectrum of bleeding disorders.
KW - antifibrinolytic agents
KW - coagulants
KW - fibrin modulating agents
KW - heavy menstrual bleeding
KW - hematologic agents
KW - hematologic disorders
KW - hemophilia
KW - hemorrhage
KW - hemostatic
KW - postpartum hemorrhage
KW - tranexamic acid
KW - trauma
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U2 - 10.1111/ejh.13348
DO - 10.1111/ejh.13348
M3 - Review article
C2 - 31729076
AN - SCOPUS:85076908072
SN - 0902-4441
VL - 104
SP - 79
EP - 87
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 2
ER -