Study results show TXA did not increase blood clots at 90-days follow-up

Editor's Note
Recent findings from the TRACTION study in which patients undergoing higher-risk non-cardiac surgery received tranexamic acid (TXA) or a placebo, demonstrated that patients who received TXA, a generic drug that promotes blood clotting, needed significantly fewer blood transfusions and saw no increase in potentially life-threatening blood clots after 90 days of follow-up. These findings were presented December 9 at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition.

In this study, patients received a first dose of TXA or the placebo intravenously within minutes of surgery initiation. At the discretion of the attending anesthesiologist, they then received a second dose either at the conclusion of the operation or as a continuous infusion throughout the procedure.

These findings contrast with a 2019 study that found major bleeding to be the most common complication following non-cardiac surgery. However, findings from the TRACTION trial are similar to those from the POISE-3 trial that found, compared with patients who received a placebo, patients who received TXA immediately before and after non-cardiac surgery had significantly less serious bleeding and needed fewer blood transfusions, with no significant increase in heart attacks, strokes, or blood clots at 30 days, per the news release.

TRACTION study investigators noted that their findings demonstrating TXA use did not increase risk for blood clots during the 90-day post-surgical period of elevated risk may reassure many practitioners who have previously been hesitant to use the drug.