Tranexamic Acid and Myocardial Infarction Risk

Evidence from Large-Scale Meta-Analyses

A 2025 meta-analysis of 191 randomized controlled trials (40,621 participants) in non-cardiac surgery found no evidence of increased risk of cardiovascular thromboembolic complications, seizures, or mortality at 30 days with tranexamic acid use 1, 2
An even larger meta-analysis of 216 trials (125,550 participants) across all clinical settings found no evidence of increased risk of thromboembolic complications, supporting the general safety of TXA 1, 2

In 20,211 trauma patients, TXA actually showed a lower rate of thrombosis, especially myocardial infarction, compared to placebo 3, 4, 5, 6
While theoretical concerns about precipitated thrombosis with lysine analogues like TXA existed, the CRASH-2 data demonstrated the opposite effect 3, 4
No adverse events related to thrombosis were described with TXA use in this massive trial 3