SynthesisCardiology2025
Efficacy and Safety of Protamine Use following Transcatheter Aortic Valve Implantation for Minimizing Post-Procedural Bleeding Risk: A Systematic Review and Meta-Analysis.
Synthesis in Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTranscatheter aortic valve implantation (TAVI) may be complicated by postoperative bleeding due to heparin use. Heparin antagonists, such as protamine, have shown potential in reducing bleeding risks. This meta-analysis assesses the efficacy and safety of protamine in reducing bleeding complications after TAVI.
methodsA systematic search was conducted up to March 2025. Inclusion criteria encompassed studies reporting the use of protamine post-TAVI with a control group. Primary outcomes included major bleeding events as the efficacy endpoint, 30-day mortality, and ischemic events (stroke and transient ischemic attack, or TIA) as safety endpoints. Secondary outcomes included life-threatening bleeding events and the need for blood transfusion. A random-effects model was used to calculate odds ratios (ORs).
resultsFour studies involving 1,569 patients were included. As compared to the control group, protamine was not associated with a statistically significant difference in major bleeding events (OR = 0.59, 95% CI = 0.26-1.34, p = 0.21), life-threatening bleeding events (OR = 0.3, 95% CI = 0.06-1.62, p = 0.16), need for blood transfusions (OR = 0.75, 95% CI = 0.46-1.24, p = 0.27), 30-day mortality (OR = 1.07, 95% CI = 0.54-2.11, p = 0.85), or rate of stroke and TIA (OR = 0.86, 95% CI = 0.05-13.58, p = 0.91).
conclusionProtamine use after TAVI appeared to be safe with no increase in 30-day mortality or stroke and TIA rates, but there was no observed statistically significant benefit in the reduction of major or life-threatening bleeding events and the need for blood transfusions. These findings are based on a limited number of studies, and larger randomized controlled trials are warranted to confirm them.
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