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Heart Drug Carries Dangers

Study says protamine after bypass surgery causes blood pressure to drop

TUESDAY, March 25, 2003 (HealthDayNews) -- Protamine, a drug commonly used following heart bypass surgery, has more dangerous side effects than previously recognized, says a Duke University Medical Center study.

The finding was presented March 25 at the 77th Clinical and Scientific Congress of the International Anesthesia Research Society in New Orleans.

The Duke researchers found that small blood pressure changes that often occur in patients who are given protamine are associated with increased risk of death. Despite that, the study authors don't advocate any change in the clinical use of the drug.

But they emphasize the study findings should encourage development of alternatives to protamine.

Protamine, which has been used for more than 40 years, is given to people after they have coronary artery bypass surgery to counteract the effects of the blood-thinning drug heparin, which is used during the surgery.

The Duke researchers analyzed records of 6,921 people who had bypass surgery at Duke. The researchers correlated the degrees of protamine-related blood pressure changes with the incidence of patient deaths in the hospital.

They found that 19 percent of the bypass patients had average blood pressure drops of 20 percent or more during the 30 minutes after they received protamine. That blood pressure drop was significantly associated with in-hospital death.

The study also found that each incremental decrease in blood pressure translated into an additional 30 percent greater chance of in-hospital death.

In addition to reducing blood pressure, protamine may also reduce heart function, activate certain immune system responses, and cause pulmonary hypertension.

More information

Here's where you can learn more about bypass surgery.

SOURCE: Duke University Medical Center, news release, March 25, 2003
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