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Blood-thinning drug can reduce death risk post non-cardiac surgery

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Health Desk: 13 March 2018: Dabigatran, a blood thinning drug, can significantly reduce the risk of death after non-cardiac surgery.

Researchers in Hamilton have discovered that the blood thinner lowers the risk of death, heart attack, stroke, and other heart or blood-vessel complications in patients who have a heart injury following major, non-cardiac surgery.

Every year, approximately eight million people worldwide develop a condition called myocardial injury after noncardiac surgery (MINS), which refers to damage incurred to the tissue of the heart in response to the stress of surgery on the body.

The condition affects patients undergoing major procedures such as a hip or knee replacement, bowel resection, or abdominal aortic aneurysm repair, and can lead to severe complications including heart attack, stroke, blood clots, amputations, and death.

In the first randomized controlled trial to evaluate a treatment for MINS, Dr. P.J. Devereaux, scientific lead for perioperative research at the Population Health Research Institute (PHRI) of Hamilton Health Sciences and McMaster University and principal investigator for the MANAGE trial, found that patients who had MINS and received dabigatran twice daily were 28 per cent less likely to suffer a major vascular complication during an average of 16 months of follow-up.

The study enrolled 1,754 patients in 19 countries, 51 percent of whom were male, with an average age of 70 years.

After an average follow-up of 16 months, 11 percent of patients treated with dabigatran experienced a MINS-related event, compared with 15 percent of patients who received a placebo. This translates to a 28 percent reduction in risk for patients receiving dabigatran.

An increased risk of bleeding is an expected complication of treatment with a blood-thinning medication; however, there was no significant difference between the two groups in terms of life-threatening, major, or critical organ bleeding.

The MANAGE study builds on the discovery made by Dr. Devereaux and his colleagues last year which showed that a simple blood test could identify patients with MINS following surgery and alert clinicians to intervene before complications occurred.

The results of the MANAGE trial were presented at the American College of Cardiology's 67th Annual Scientific Session. (ANI)