Document Detail


Antithrombotic treatment (argatroban vs. heparin) in coronary angioplasty in angina pectoris: effects on inflammatory, hemostatic, and endothelium-derived parameters.
MedLine Citation:
PMID:  10822073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the suitability of two anticoagulants (heparin vs. argatroban) as adjunctive drugs during and after elective conventional percutaneous transluminal coronary angioplasty, we compared the changes in inflammatory, hemostatic, and endothelium-derived markers in groups of patients with stable angina treated with the two drugs during percutaneous transluminal coronary angioplasty. Twenty-seven patients were randomly allocated to either group 1 (15 patients who received an empiric dose of heparin and aspirin as anticoagulant), or group 2 (12 patients who received an alternative regimen of argatroban and aspirin). Both drugs were administered as a bolus followed by continuous infusion for 96 hours during and after percutaneous transluminal coronary angioplasty. There were no differences in the inflammatory response induced by percutaneous transluminal coronary angioplasty in both groups, but the fibrinogen concentration significantly decreased during percutaneous transluminal coronary angioplasty in group 2. Decreased platelet counts and increased mean platelet volume were observed during percutaneous transluminal coronary angioplasty in both groups. The levels of prothrombin fragment 1+2 and thrombin antithrombin III complex increased markedly during percutaneous transluminal coronary angioplasty. Group 2 showed a more rapid return to the baseline levels of these two markers than group 1. Secondary fibrinolysis was evidenced by a steep increase of D-dimer after percutaneous transluminal coronary angioplasty in both groups. In contrast to the significant decrease in antithrombin activities during percutaneous transluminal coronary angioplasty in group 1, no marked change in these markers was found in group 2. Although the levels of von Willebrand factor and plasminogen activator inhibitor-1 showed essentially the same changes in both groups during and after percutaneous transluminal coronary angioplasty, more markedly increased levels of tissue type plasminogen activator and type plasminogen activator-plasminogen activator inhibitor-1 complex after percutaneous transluminal coronary angioplasty were found in group 1 than in group 2. While neither drug had any effect on the percutaneous transluminal coronary angioplasty-induced inflammatory response, argatroban may more effectively inhibit the generated thrombin and prevent antithrombin consumption during and after percutaneous transluminal coronary angioplasty.
Authors:
S Suzuki; T Matsuo; H Kobayashi; M Matsuo; C Shimamo; M Koide; S Sakamoto
Related Documents :
8258113 - Left atrial appendage smoke-like echo in dilated cardiomyopathy: its clinical significa...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Thrombosis research     Volume:  98     ISSN:  0049-3848     ISO Abbreviation:  Thromb. Res.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-10-02     Completed Date:  2000-10-02     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  269-79     Citation Subset:  IM    
Affiliation:
Hyogo Prefectural Awaji Hospital, 1-6-6, Shimogamo, Hyogo 656-0013, Sumoto, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / drug therapy,  therapy*
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Anticoagulants / therapeutic use*
Antithrombin III / analysis
Aspirin / therapeutic use
Biological Markers
Combined Modality Therapy
Endothelium, Vascular / drug effects*,  metabolism
Female
Fibrinolysin / analysis
Fibrinolytic Agents / therapeutic use*
Hemostasis / drug effects*
Heparin / therapeutic use*
Heparin Cofactor II / analysis
Humans
Inflammation / etiology
Male
Middle Aged
Peptide Fragments / analysis
Peptide Hydrolases / analysis
Pipecolic Acids / therapeutic use*
Plasminogen Activator Inhibitor 1 / analysis
Plasminogen Activator Inhibitor 2 / analysis
Platelet Count
Prothrombin / analysis
Tissue Plasminogen Activator / analysis
alpha-2-Antiplasmin / analysis
von Willebrand Factor / analysis
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Biological Markers; 0/Fibrinolytic Agents; 0/Peptide Fragments; 0/Pipecolic Acids; 0/Plasminogen Activator Inhibitor 1; 0/Plasminogen Activator Inhibitor 2; 0/alpha-2-Antiplasmin; 0/antithrombin III-protease complex; 0/prothrombin fragment 1.2; 0/von Willebrand Factor; 50-78-2/Aspirin; 74863-84-6/argatroban; 81604-65-1/Heparin Cofactor II; 9000-94-6/Antithrombin III; 9001-26-7/Prothrombin; 9005-49-6/Heparin; EC 3.4.-/Peptide Hydrolases; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.7/Fibrinolysin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Platelet-derived microparticles in patients with arteriosclerosis obliterans: enhancement of high sh...
Next Document:  Platelet glycoprotein Ia gene dimorphism alpha2-807 in malignant arrhythmia in coronary artery disea...