Patients with decompensated cirrhosis are at risk for hyperfibrinolysis; this is potentially fatal. ɛ-aminocaproic acid has been used to treat patients with hyperfibrinolysis; however, the data about its benefit in the setting of cirrhosis are minimal.
To analyse the efficacy of ɛ-aminocaproic acid and its safety in cirrhotic patients with hyperfibrinolysis.
All patients with an abnormal euglobin lysis time who were admitted to Rancho Los Amigos Medical Center from 1 January 2001 to 31 December 2002 were included in the study. Their medical records were reviewed and analysed.
There were 60 cirrhotic patients with shortened euglobin lysis time. Fifty-two patients received ɛ-aminocaproic acid. Of the 52 patients, seven had one or more bleeding episodes with the subcutaneous or soft tissue bleeding as the most common indication for ɛ-aminocaproic acid use. Of the 37 patients, 34 (92%) had improvement or resolution of their bleeding. Only two (3%) patients had ɛ-aminocaproic acid treatment discontinued because of minor side effects, rash and lightheadedness. There were no thromboembolic complications of treatment.
ɛ-aminocaproic acid was found to be effective and safe for treatment of hyperfibrinolysis in patients with cirrhosis.