What is the risk of thrombosis in non-surgical patients treated with systemic tranexamic acid?

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Why is this study important?

Tranexamic acid (TXA) inhibits the activation of plasminogen into plasmin, the major enzyme in the degradation of fibrin. Hence, TXA is a prothrombotic agent with the opposite mechanism of action and effect of tissue plasminogen activator (tPA). However, as a clot-preserving agent, it has the potential to increase the risk of thrombosis including ischemic stroke, myocardial infarction (IM), and venous thromboembolism (VTE) (i.e., pulmonary embolism [PE], and deep vein thrombosis [DVT]). This review summarizes the risk of complications and treatment effect for systemic TXA in non-surgical patients.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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