| Long term administration of LMWH - pharmacodynamic parameters under therapeutic or prophylactic regimen of enoxaparin or tinzaparin in neurological rehabilitation patients. | |
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MedLine Citation:
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PMID: 19625075 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We investigated anti-FXa- and anti-FIIa-activity, thrombin generation (ETP), tissue factor pathway inhibitor (TFPI) - and D-dimer in patients exhibiting high bleeding risk in early neurological rehabilitation over 2 months in an observational study. Blood of 64 patients under LMWH administration due to therapeutic (cohort 1 [tinzaparin 90 IE/kg BID, N = 18] and 2 [enoxaparin 100 IE/kg BID; N = 15]) or prophylactic (cohort 3 [tinzaparin 4500 IE; N = 16] and 4 [enoxaparin 4000 IE; N = 15]) indication was drawn before and 4h after injection on day 7 (V1) and 2 months (follow up [V2]). Although the dose in cohort 1 and 2 was similar (median 7000 IE BID), a-FXa-activity was significantly larger under enoxaparin than under tinzaparin (e.g. median at V2: 0.70 IU/ml vs. 0.33 IU/ml). Also, prophylactic enoxaparin exhibited larger a-FXa-activity than tinzaparin (e.g. median at V2: 0.37 IU/ml vs. 0.22 IU/ml). The a-FXa/a-FIIa-ratio in plasma samples at 4h p.a. was about 4 (tinzaparin) and 8 (enoxaparin), respectively. No differences were seen for TFPI and ETP between cohort 1 and 2 or between cohort 3 and 4. D-dimer levels decreased significantly between V1 (e.g. cohort 4 median 1940 ng/ml) and V2 (median 652 ng/ml). Minimal bleeding events occurred in 6 patients (2 under tinzaparin, 4 under enoxaparin) and were associated with significantly higher anti-FXa-activity. In conclusion, although marked differences between tinzaparin and enoxaparin based on anti-FXa-activity were seen, markers of in vivo biological activity such as TFPI and D-dimer were not different. Furthermore, BID tinzaparin is a feasible option for therapeutic anticoagulation in patients with high bleeding risk. |
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Authors:
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K Kuczka; K Baum; B Picard-Willems; S Harder |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-07-21 |
Journal Detail:
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Title: Thrombosis research Volume: 124 ISSN: 1879-2472 ISO Abbreviation: Thromb. Res. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-19 Completed Date: 2010-02-18 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: 625-30 Citation Subset: IM |
Affiliation:
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Pharmazentrum frankfurt/ZAFES, Institute of Clinical Pharmacology at the Johann Wolfgang Goethe University Frankfurt, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Anticoagulants / administration & dosage* Drug Administration Schedule Enoxaparin / administration & dosage* Female Fibrin Fibrinogen Degradation Products / metabolism Fibrinolytic Agents / administration & dosage* Hemorrhage / chemically induced, drug therapy, prevention & control* Heparin, Low-Molecular-Weight / administration & dosage* Humans Lipoproteins / metabolism Male Middle Aged Nervous System Diseases / blood*, rehabilitation* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Enoxaparin; 0/Fibrin Fibrinogen Degradation Products; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 0/Lipoproteins; 0/fibrin fragment D; 0/lipoprotein-associated coagulation inhibitor; 0/tinzaparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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