FREE: Effect of High- vs Low-Dose Tranexamic Acid Infusion on Need for Red Blood Cell Transfusion and Adverse Events in Patients Undergoing Cardiac Surgery: The OPTIMAL Randomized Clinical Trial.

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In this randomized clinical trial that included 3031 patients, high-dose compared with low-dose tranexamic acid infusion significantly reduced the proportion of patients who received allogeneic red blood cell transfusion (21.8% vs 26.0%, respectively). The rate of a composite safety end point of 30-day mortality, seizure, kidney dysfunction, and thrombotic events was 17.6% in the high-dose group and 16.8% in the low-dose group; the 97.55% CI for the difference was within the noninferiority margin of 5%.