Document Detail


Argatroban, a direct thrombin inhibitor for heparin-induced thrombocytopaenia: present and future perspectives.
MedLine Citation:
PMID:  16370925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heparin remains the most commonly used anticoagulant in the treatment of patients with acute vascular syndromes, including myocardial infarction, unstable angina and ischaemic stroke. However, heparin therapy is not always associated with a significant improvement of clinical outcomes, is linked with enhanced bleeding risk and can occasionally provoke the development of heparin-induced thrombocytopaenia, the most devastating complication of conventional therapy with unfractioned heparin. Understanding the key role of thrombin in clot formation and platelet activation has stimulated the development of a new class of drugs - direct thrombin inhibitors. The direct thrombin inhibitor argatroban has been known for decades. Similar to the unfractioned heparin, argatroban requires intravenous administration and activated partial prothrombin time-dependent dose adjustment; however, this pharmacological agent has a relatively short half-life that broadens its safety margins, as well as its low antigenic potential due to the small molecular weight of the compound. The efficacy of argatroban has been demonstrated among patients with acute coronary syndromes and stroke. However, this drug is currently approved by the FDA only for the treatment of patients with heparin-induced thrombocytopaenia. Indeed, in such patients, argatroban significantly improves clinical outcomes, and is associated with reduced mortality. Further clinical studies are needed to present more clinical evidence necessary to broad the indication spectrum of this agent.
Authors:
Michael V Serebruany; Alex I Malinin; Victor L Serebruany
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  7     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-22     Completed Date:  2006-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  81-9     Citation Subset:  IM    
Affiliation:
HeartDrug Research Laboratories, Johns Hopkins University, 7600 Osler Drive, Suite 307, Towson, Maryland 21204, USA. heartdrug@aol.com
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MeSH Terms
Descriptor/Qualifier:
Animals
Antithrombins / chemistry,  pharmacokinetics,  therapeutic use*
Forecasting
Heparin / adverse effects*
Humans
Pipecolic Acids / chemistry,  pharmacokinetics,  therapeutic use*
Thrombocytopenia / chemically induced,  drug therapy*
Chemical
Reg. No./Substance:
0/Antithrombins; 0/Pipecolic Acids; 74863-84-6/argatroban; 9005-49-6/Heparin

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


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