Efficacy and Safety of Prothrombin Complex Concentrate Compared to Fresh Frozen Plasma in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Coagulopathy and bleeding are common complications following cardiac surgery, often requiring the use of hemostatic agents such as prothrombin complex concentrate (PCC) or fresh frozen plasma (FFP). This systematic review and meta-analysis compared the efficacy and safety of PCC versus FFP in adult patients undergoing cardiac surgery complicated by bleeding or coagulopathy. A comprehensive search of PubMed, Embase, and Web of Science was conducted from inception to March 30, 2025, identifying randomized controlled trials comparing these interventions. Primary outcomes included chest tube drainage within 24 hours, the number of red blood cell (RBC) units transfused, and the proportion of patients requiring RBC transfusion. Secondary outcomes were hospital and intensive care unit length of stay, the incidence of stroke or transient ischemic attack, thromboembolic events, acute kidney injury, and all-cause mortality within 30 days. Four randomized controlled trials, including 671 patients (PCC: 343; FFP: 328), were analyzed. PCC significantly reduced chest tube output [mean difference = -162.12 mL, 95% confidence interval (CI): -264.46 to -59.78, P = 0.002], number of RBC units transfused (mean difference = -0.93, 95% CI: -1.34 to -0.51, P < 0.0001), and proportion of patients requiring RBC transfusion (risk ratio = 0.81, 95% CI: 0.71-0.91, P = 0.0007). No significant differences were found in intensive care unit/hospital stay, thromboembolic events, stroke/transient ischemic…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 671 participants or records.
Read the paper
Related studies
- Safety and efficacy of COVID‐19 vaccines: A systematic review and meta‐analysis of controlled and randomized clinical trials
- Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies
- Determinants of passive antibody efficacy in SARS-CoV-2 infection: a systematic review and meta-analysis
- Cleaning efficacy of EDDY versus ultrasonically-activated irrigation in root canals: a systematic review and meta-analysis
- Bonding Efficacy of Universal Resin Adhesives to Zirconia Substrates: Systematic Review and Meta-Analysis
- In vitro antimicrobial activity of extracts and essential oils of Cinnamomum, Salvia, and Mentha spp. against foodborne pathogens: A meta-analysis study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.