Document Detail

In vitro comparison of dabigatran, unfractionated heparin, and low-molecular-weight heparin in preventing thrombus formation on mechanical heart valves.
MedLine Citation:
PMID:  20659761     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Lifelong oral anticoagulation (OAC) therapy is required for the prevention of thromboembolic events after implantation of an artificial heart valve. Thromboembolism and anticoagulant-related bleedings account for approximately 75% of all complications experienced by heart valve recipients (2-9% of patients per year). The present study investigated the efficacy of dabigatran, a new direct thrombin inhibitor for oral use, as compared to unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) in preventing thrombus formation on mechanical heart valves in vitro.
MATERIAL AND METHODS: Blood (230 ml) from healthy young male volunteers was anticoagulated either by dabigatran (1 micromol/l), UFH (150 IU), or LMWH (100 IU). Mechanical heart valve prostheses were placed in an in vitro thrombosis tester and exposed to the anticoagulated blood samples under continuous circulation at a rate of 75 beats per minute.
RESULTS: In whole blood with no anticoagulant, the apparatus completely clotted in 15-20 minutes. When blood was treated with dabigatran, the mean thrombus weight was 164+/-55 mg, in the UFH group 159+/-69 mg, and in the LMWH group 182+/-82 mg (p-value: 0.704). Electron microscopy showed no significant difference in thrombus formation in any group.
CONCLUSIONS: Dabigatran was as effective as UFH and LMWH in preventing thrombus formation on mechanical heart valves in our in vitro investigation. Thus, we hypothesize that dabigatran etexilate might potentially be a useful and competitive orally administered alternative to UFH and LMWH for recipients of alloplastic heart valve prostheses.
Lars Maegdefessel; Torsten Linde; Franziska Krapiec; Kathrin Hamilton; Ulrich Steinseifer; Joanne van Ryn; Uwe Raaz; Michael Buerke; Karl Werdan; Axel Schlitt
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-24
Journal Detail:
Title:  Thrombosis research     Volume:  126     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-28     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e196-200     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Department of Medicine III at the University Hospital Haale (Saale), Martin-Luther-University Halle-Wittenberg, Germany.
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MeSH Terms
Administration, Oral
Anticoagulants / administration & dosage,  pharmacology*
Benzimidazoles / administration & dosage,  pharmacology*
Blood Coagulation / drug effects*
Fibrinolytic Agents / administration & dosage,  pharmacology*
Heart Valve Prosthesis / adverse effects*
Heparin / administration & dosage,  pharmacology*
Heparin, Low-Molecular-Weight / administration & dosage,  pharmacology*
Prosthesis Design
Pyridines / administration & dosage,  pharmacology*
Thrombosis / blood,  etiology,  prevention & control*
Time Factors
Reg. No./Substance:
0/Anticoagulants; 0/Benzimidazoles; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 0/Pyridines; 2E18WX195X/dabigatran etexilate; 9005-49-6/Heparin

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