Successful Long-Term Management of Aneurysm-Associated Chronic Disseminated Intravascular Coagulation with Low Molecular Weight Heparin

2012 ◽  
Vol 27 (6) ◽  
pp. 730-735 ◽  
Author(s):  
Julia H. Perry ◽  
Harold L. Lazar ◽  
Karen Quillen ◽  
J. Mark Sloan
Keyword(s):  
Molecular Weight ◽  
Disseminated Intravascular Coagulation ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Intravascular Coagulation ◽  
Term Management

Human Urinary Soluble Thrombomodulin (MR-33) Improves Disseminated Intravascular Coagulation without Affecting Bleeding Time in Rats: Comparison with Low Molecular Weight Heparin

1997 ◽  
Vol 77 (04) ◽  
pp. 789-795 ◽  
Author(s):  
Yasuo Takahashi ◽  
Yoshitaka Hosaka ◽  
Kazunori Imada ◽  
Takehiro Adachi ◽  
Hiromi Niina ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Disseminated Intravascular Coagulation ◽  
Low Molecular Weight Heparin ◽  
Bleeding Time ◽  
Low Molecular Weight ◽  
Soluble Thrombomodulin ◽  
Intravascular Coagulation ◽  
Significant Prolongation ◽  
Dose Dependent Fashion ◽  
Dose Dependent

SummaryWe compared the antithrombotic and hemorrhagic effects of naturally existing human urinary soluble thrombomodulin (MR-33) with those of low molecular weight heparin (LMW-heparin) in rats. In in vitro experiments, MR-33 prolonged APTT in a dose-dependent fashion; its effect in this respect was as potent as that of LMW-heparin, but it was less potent than unfractionated heparin (UF-heparin). MR-33 was effective on endotoxin- or thromboplastin-induced disseminated intravascular coagulation (DIC) in rats. In both DIC models, infusion of MR-33 improved hematological abnormalities compatible with DIC in a dose-dependent fashion without excessive prolongation effect on APTT. Although LMW-heparin and UF-heparin also improved both DIC models, excessive prolongation of APTT was observed at high doses. It is well-known that the excessive prolongation of APTT with antithrombotic drugs like heparins is an index for hemorrhage, which is a major side effect in the treatment of DIC. We therefore further compared the antithrombotic (Benefit: dose required for 50% inhibition of fibrinogen decrease: ED50) and hemorrhagic (Risk: minimum dose required for significant prolongation of bleeding time) effects of MR-33 and LMW-heparin in the thromboplastin-induced DIC model. As a result, Benefit-Risk ratio was 1:27 for MR-33 and 1:3 for LMW heparin. These results indicate that MR-33 may be a clinically useful antithrombotic agent with reduced risk for hemorrhage compared with LMW-heparin.

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