REVIEW ARTICLEThe effect of tranexamic acid on myocardial injury in cardiac surgical patients: a systematic review and meta-analysisWang, Xiaoa; Li, Linga; He, Lixianb; Yao, Yuntaib Author Information aDepartment of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital, Yunnan Province, Kunming bDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China Correspondence to Yuntai Yao, MD, PhD, Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China E-mail: [email protected] Received 5 April, 2021 Revised 6 June, 2022 Accepted 5 July, 2022 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.bloodcoagulation.com). Blood Coagulation & Fibrinolysis: December 2022 - Volume 33 - Issue 8 - p 429-437 doi: 10.1097/MBC.0000000000001158 Buy SDC Metrics Abstract Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic agents for surgical patients. However, the effect of TXA on myocardial injury remains controversial. We systemically reviewed literature regarding the effectiveness of TXA on myocardial injury in patients who have undergone a cardiac surgery. We included all randomized controlled trials (RCTs) comparing TXA and control (saline) in cardiac surgical patients. Relevant studies were identified by a comprehensive electronic literature search from database inception to 15 August 2021. A standardized data extraction form was used to collect methodological and outcome variables from each eligible study. We conducted a meta-analysis to estimate the pooled effect size of TXA administration on myocardial injury. In total, eight RCTs were identified, with 292 patients in the TXA group, and 241 patients in saline or control group. The meta-analysis demonstrated that patients in the TXA group had lower levels of CK-MB and cTnI within 24 h postoperatively (CK-MB: P = 0.005; cTnI: P = 0.01), compared with the saline group. No significant difference was found with respect to AST level (P = 0.71) between TXA and saline groups within 24 h postoperatively. TXA administration was found to be associated with less myocardial injury among patients who have undergone cardiac surgery. High-quality randomized controlled trials are warranted to further examine the cardioprotective effects of TXA. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.