Acute cardiac care & resuscitation

Topical Versus Intravenous Tranexamic Acid in Patients Undergoing Cardiac Surgery: The DEPOSITION Randomized Controlled Trial

CirculationPublished Randomised controlled trial

Primary result · In-hospital seizureResult — go to the resultAbsolute risk difference −0.5% 95% CI −0.9 to 0.03
  • stopped early for safety
  • Stopped early for safety on data and safety monitoring board recommendation after the last planned interim analysis (75% of anticipated participants followed up)

Authors' conclusion

Among patients undergoing cardiac surgery, topical administration of tranexamic acid resulted in an 8.3% absolute increase in transfusion without reducing the incidence of seizure, compared with intravenous tranexamic acid.

Study context

Population
Patients undergoing cardiac surgery with cardiopulmonary bypass, 16 academic hospitals in 6 countries3,242 randomized (as printed)
Participants
1,624 vs 1,628
Comparison
Topical vs intravenous tranexamic acid
  • Topicaln = 1,624
  • Intravenousn = 1,628reference
Primary endpoint
In-hospital seizure
Methodological detailsmulticentre, double dummy, blinded
  • Multicentre
  • Double dummy
  • Blinded

Primary result

As reported in the abstract

Absolute risk difference

−0.5%

95% CI −0.9 to 0.03

P = 0.07

Events by treatment group

Topicalvs Intravenous
absolute risk difference −0.5% (95% CI −0.9 to 0.03); P = 0.07

Secondary outcomes

OutcomeTopicalIntravenousAbsolute risk difference (95% CI)P value
Red blood cell transfusion35.1%26.8%8.3% (5.2–11.5)P = 0.007
Transfusion of ≥4 units of red blood cells8.2% (3.4–12.9)

Original publication

Topical Versus Intravenous Tranexamic Acid in Patients Undergoing Cardiac Surgery: The DEPOSITION Randomized Controlled Trial. Circulation. Published 8 April 2024. doi:10.1161/circulationaha.124.069606

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