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Author Notes:

Correspondence: Lawrence T. Goodnough, MD, Departments of Pathology and Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Rm H-1402, M/C 5626, Stanford, CA 94305-5626 (Ltgoodno@stanford.edu)

The authors thank Ms Ingrid Liu for statistical support.

Disclosures: Authors have nothing to disclose with regard to commercial support.


Research Funding:

This work was sponsored by Daiichi Sankyo, Inc, Parsippany, NJ, and Eli Lilly and Co, Indianapolis, Ind, and is related to study protocol H7T-MC-TAAL, listed on ClinicalTrials.gov (NCT00097591).

Dr Smith was supported by National Heart, Lung, and Blood Institute (grant U01-HL088953).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Respiratory System
  • Surgery
  • Cardiovascular System & Cardiology

Transfusion outcomes in patients undergoing coronary artery bypass grafting treated with prasugrel or clopidogrel: TRITON-TIMI 38 retrospective data analysis

Journal Title:

Journal of Thoracic and Cardiovascular Surgery


Volume 145, Number 4


, Pages 1077-1082.e4

Type of Work:

Article | Post-print: After Peer Review


Objective: Coronary artery bypass grafting-related bleeding and associated transfusion is a concern with dual antiplatelet therapy in patients with acute coronary syndromes. The objective of the present study was to characterize a potential risk-adjusted difference in transfusion requirements between prasugrel and clopidogrel cohorts. Methods: The data from 422 patients undergoing isolated coronary artery bypass grafting from the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel Thrombolysis In Myocardial Infarction 38 were analyzed retrospectively. Results: We found no difference in baseline transfusion risk scores between cohorts. As predicted, the number of units of red blood cells transfused perioperatively correlated with the transfusion risk score (P < .0001). Overall, the 12-hour chest tube drainage volumes and platelet transfusion rates in the prasugrel cohort were significantly greater. However, no statistically significant differences were found in the number of red blood cell transfusions, total hemostatic components transfused, or total blood donor exposure. A significantly greater number of platelet units were transfused postoperatively in the prasugrel patients who underwent surgery within 5 days or less after withdrawal of drug. In an analysis adjusted for the predicted risk of mortality, total donor exposure was not associated with increased mortality. Conclusions: The use of prasugrel compared with clopidogrel was associated with greater 12-hour chest tube drainage volumes and platelet transfusion rates but without any significant differences in red blood cell transfusions, total hemostatic components transfused, or total blood donor exposure.

Copyright information:

© 2013 by The American Association for Thoracic Surgery.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nd/4.0/).

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