| In vitro comparison of dabigatran, unfractionated heparin, and low-molecular-weight heparin in preventing thrombus formation on mechanical heart valves. | |
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MedLine Citation:
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PMID: 20659761 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Lars Maegdefessel; Torsten Linde; Franziska Krapiec; Kathrin Hamilton; Ulrich Steinseifer; Joanne van Ryn; Uwe Raaz; Michael Buerke; Karl Werdan; Axel Schlitt |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-07-24 |
Journal Detail:
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Title: Thrombosis research Volume: 126 ISSN: 1879-2472 ISO Abbreviation: Thromb. Res. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-30 Completed Date: 2010-12-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0326377 Medline TA: Thromb Res Country: United States |
Other Details:
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Languages: eng Pagination: e196-200 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Medicine III at the University Hospital Haale (Saale), Martin-Luther-University Halle-Wittenberg, Germany. maegdefessel@stanford.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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* Humans Male Prosthesis Design Pyridines / administration & dosage, pharmacology* Thrombosis / blood, etiology, prevention & control* Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Benzimidazoles; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 0/Pyridines; 211915-06-9/dabigatran etexilate; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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