Current antifibrinolytic therapy for coronary artery revascularization

The use of antifibrinolytic therapy is commonplace in coronary artery revascularization procedures. Cardiac surgery accounts for more than 700,000 surgeries per year, with approximately 70% of these cases requiring antifibrinolytic therapy for coronary artery bypass graft (CABG) procedures. Two main classes of antifibrinolytics are used in CABG procedures: synthetic lysine analogues and serine protease inhibitors. Both classes of antifibrinolytics have been shown to decrease the incidence of blood transfusions. However, new data have emerged regarding an increase in adverse outcomes associated with serine protease inhibitors. The purpose of this review article is to describe the clinical significance of antifibrinolytic therapy and the current implications associated with its use.