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https://www.readbyqxmd.com/read/28074788/comparison-of-two-doses-of-heparin-on-outcome-in-off-pump-coronary-artery-bypass-surgery-patients-a-prospective-randomized-control-study
#1
Murali Chakravarthy, Dattatreya Prabhakumar, Patil Thimmannagowda, Jayaprakash Krishnamoorthy, Antony George, Vivek Jawali
INTRODUCTION: While off pump coronary artery bypass surgery is practiced with an intention to reduce the morbidity associated with cardiopulmonary bypass, the resultant 'hypercoagulability' needs to be addressed. Complications such as cavitary thrombus possibly due to the hyper coagulability after off pump coronary artery bypass surgery have been described. Many clinicians use higher doses of heparin - up to 5 mg/kg in order to thwart this fear. Overall, there appears to be no consensus on the dose of heparin in off pump coronary artery bypass surgeries...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073784/platelets-and-neutrophil-extracellular-traps-collaborate-to-promote-intravascular-coagulation-during-sepsis-in-mice
#2
Braedon McDonald, Rachelle P Davis, Seok-Joo Kim, Mandy Tse, Charles T Esmon, Elzbieta Kolaczkowska, Craig N Jenne
Neutrophil extracellular traps (NETs; webs of DNA coated in anti-microbial proteins) are released into the vasculature during sepsis where they contribute to host defense, but also cause tissue damage and organ dysfunction. Various components of NETs have also been implicated as activators of coagulation. Using multi-color confocal intravital microscopy in mouse models of sepsis, we observed profound platelet aggregation, thrombin activation, and fibrin clot formation within (and downstream of) NETs in vivo...
January 10, 2017: Blood
https://www.readbyqxmd.com/read/28053193/promyelocytic-extracellular-chromatin-exacerbates-coagulation-and-fibrinolysis-in-acute-promyelocytic-leukemia
#3
Muhua Cao, Tao Li, Zhangxiu He, Lixiu Wang, Xiaoyan Yang, Yan Kou, Lili Zou, Xue Dong, Valerie A Novakovic, Yayan Bi, Junjie Kou, Bo Yu, Shaohong Fang, Jinghua Wang, Jin Zhou, Jialan Shi
Despite routine treatment of unselected acute promyelocytic leukemia (APL) with all-trans-retinoic acid (ATRA), early death due to hemorrhage remains unacceptably common and the mechanism underlying this complication remains elusive. We have recently demonstrated that APL cells undergo a novel cell death program, termed ETosis, which involves release of extracellular chromatin. However, the role of promyelocytic extracellular chromatin in APL-associated coagulation remains unclear. Our objectives were to identify the novel role of ATRA-promoted extracellular chromatin in inducing a hypercoagulable and hyperfibrinolytic state in APL and to evaluate its interaction with fibrin and endothelial cells (ECs)...
January 4, 2017: Blood
https://www.readbyqxmd.com/read/28052306/laboratory-monitoring-of-parenteral-direct-thrombin-inhibitors
#4
Elizabeth M Van Cott, A Joshua Roberts, William E Dager
Argatroban and bivalirudin are parenteral direct inhibitors of the activity of thrombin, but, unlike heparin, can inhibit both soluble as well as clot-bound thrombin. These agents do not require antithrombin as a cofactor for activity. The parenteral direct thrombin inhibitors (DTIs) can be used in a variety of settings, including heparin-induced thrombocytopenia (HIT) or an allergy to heparin, and patients requiring anticoagulation for an invasive cardiovascular intervention. Both agents have a relatively short half-life in patients without organ system failure and are typically administered by continuous infusion...
January 4, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28007922/synergistic-interaction-between-phage-therapy-and-antibiotics-clears-pseudomonas-aeruginosa-infection-in-endocarditis-and-reduces-virulence
#5
Frank Oechslin, Philippe Piccardi, Stefano Mancini, Jérôme Gabard, Philippe Moreillon, José M Entenza, Gregory Resch, Yok-Ai Que
BACKGROUND: Increasing antibiotic resistance warrants therapeutic alternatives. Here we investigated the efficacy of bacteriophage-therapy (phage) alone or combined with antibiotics against experimental endocarditis (EE) due to Pseudomonas aeruginosa, an archetype of difficult-to-treat infection. METHODS: In vitro fibrin-clots and rats with aortic EE were treated with an anti-pseudomonas phage cocktail alone or combined with ciprofloxacin. Phage pharmacology, therapeutic efficacy, and resistance were determined...
December 22, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27993886/acquired-dysfibrinogenemia-caused-by-autoantibody-inhibiting-fibrin-polymerization-in-a-patient-with-melas-syndrome-and-bleeding-tendency
#6
Nuri Lee, Ji-Eun Kim, Hyun Ju Yoo, JaYoon Gu, Hyori Kim, Junho Chung, Youngil Koh, Hyun Kyung Kim
We present a case of acquired dysfibrinogenemia caused by an autoantibody that inhibited fibrin polymerization in a patient previously diagnosed with MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, stroke-like episodes). The patient showed prolonged PT, aPTT, and thrombin time. There was no factor deficiency but fibrinogen antigen and activity were decreased. ELISA for detection of fibrinogen antibodies were performed and IgG purified from the patient's plasma bound to fibrinogen more strongly than did control IgG, indicating the presence of a fibrinogen-specific antibody...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27988438/detection-of-lupus-anticoagulant-in-the-era-of-direct-oral-anticoagulants
#7
REVIEW
Ariela Hoxha, Alessandra Banzato, Amelia Ruffatti, Vittorio Pengo
Lupus anticoagulant (LAC) is an in vitro phenomenon determining a phospholipid-dependent elongation of clotting times. The presence of LAC associated with anticardiolipin (aCL) and anti-β2 glycoprotein I (anti-β2GPI) antibodies is strongly associated with thrombosis and pregnancy morbidity. Direct oral anticoagulants (DOACs) targeting thrombin and factor Xa are currently widely use to prevent and treat venous and arterial thromboembolism. Some concern has, however, been expressed about the possibility of false laboratory results during LAC assessment in patients taking these drugs...
December 15, 2016: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27986971/management-of-bleeding-in-patients-receiving-non-vitamin-k-antagonists
#8
REVIEW
Sudarshan Balla, Scott Koerber, Greg Flaker
Anticoagulation with non-vitamin K antagonists (Non vitamin K oral anticoagulant (NOACs)) including dabigatran, rivaroxaban, apixaban and edoxaban is at least as effective as warfarin, has fewer drug and food interactions and does not require monthly monitoring. Although major bleeding with NOACs is infrequent, there remains concern about the ability to effectively treat episodes of major bleeding. New agents have been developed that are capable of providing rapid reversal of the anticoagulation effect of NOACs...
December 16, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27983747/laboratory-and-clinical-monitoring-of-direct-acting-oral-anticoagulants-what-clinicians-need-to-know
#9
Susan E Conway, Andrew Y Hwang, Charles D Ponte, John G Gums
The direct acting oral anticoagulants (DOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban, have favorable pharmacokinetic and pharmacodynamic properties and equal or superior efficacy and an improved safety profile compared to warfarin. Noted shortcomings with DOACs are shorter half-lives requiring stricter adherence, lack of standardized laboratory monitoring, lack of anticoagulation reversal agents, and loss of routine coagulation monitoring leading to fewer patient-clinician interactions. This review addresses many of these limitations including monitoring of DOACs for efficacy and toxicity, an assessment of selected qualitative and quantitative tests, and development of monitoring strategies for special populations...
December 16, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27976897/potent-selective-allosteric-inhibition-of-human-plasmin-by-sulfated-non-saccharide-glycosaminoglycan-mimetics
#10
Daniel K Afosah, Rami A Al-Horani, Nehru Viji Sankaranarayanan, Umesh R Desai
Although plasmin inhibitors could be used in multiple disorders, their use has been restricted to preventing blood loss hemostatic dysregulation because of poor efficacy and adverse effects of current agents. We reasoned that a new class of direct inhibitors that offer better efficacy, selectivity and safety could be discovered by exploiting allosterism in plasmin, a protease homologous to other allosteric serine proteases. We report on the synthesis, biological activity, and mechanism of action of a group of small molecules, called non-saccharide glycosaminoglycan mimetics (NSGMs), as direct allosteric plasmin inhibitors...
December 15, 2016: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/27973046/psychometric-validation-of-anti-clot-treatment-scale-in-japanese-patients-with-atrial-fibrillation
#11
S Cano, Y Koretsune, K Kumagai, S Uchiyama, T Yamashita, M Yasaka, S Akiyama, J Briere, T Sakaguchi, Y Okayama, E Watanabe Fujinuma
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27956417/effects-of-oritavancin-on-coagulation-tests-in-the-clinical-laboratory
#12
Adam Belley, Richard Robson, John L Francis, Dorothy M Adcock, Stefan Tiefenbacher, Christopher M Rubino, Greg Moeck, David Sylvester, Michael N Dudley, Jeffery Loutit
Previous studies have shown that some lipoglycopeptide and lipopeptide antimicrobial agents may cause falsely elevated values for some phospholipid-dependent coagulation tests. The effect of oritavancin, a lipoglycopeptide antibiotic, on coagulation test results was explored using pooled human plasma samples spiked with drug and in a clinical study after an infusion of a single 1200 mg intravenous dose of oritavancin in normal healthy volunteers. Pooled plasma with oritavancin added ex vivo showed concentration-dependent prolongation of prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (aPTT) and the dilute Russell viper venom test (DRVVT)...
December 12, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27939143/synthetic-organic-compound-vepoloxamer-p-188-potentiates-tissue-plasminogen-activator
#13
Daniel Dansdill, Pegge M Halandras, Joshua Beverly, Walter Jeske, Debra Hoppensteadt, Martin Emanuele, Jawed Fareed, Jae S Cho
OBJECTIVE: Poloxamer-188 is a synthetic, organic compound that acts by binding hydrophobic pockets on damaged lipid bilayers in the circulation. P-188 reduces blood viscosity and confers anti-inflammatory and cytoprotective effects. Vepoloxamer (Mast Therapeutics, San Diego, Calif) is a purified version of this compound that has limited side effects. The aim of this study was to investigate drug interactions between vepoloxamer and heparin and tissue plasminogen activator (tPA). METHODS: An experimental rat tail transection model was used to study vepoloxamer's interaction with heparin...
December 8, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27935987/patient-reported-treatment-satisfaction-with-rivaroxaban-for-stroke-prevention-in-atrial-fibrillation-a-french-observational-study-the-safari-study
#14
Olivier Hanon, Edouard Chaussade, Pierre Gueranger, Elise Gruson, Sabrina Bonan, Alain Gay
BACKGROUND: For antithrombotic treatments, Patient Reported Outcomes (PRO) and patient satisfaction with treatment are essential data for physicians because of the strong relationship between patient satisfaction and adherence to treatment. The impact of rivaroxaban on patient satisfaction and quality of life was not sufficiently documented in phase III studies. There is a need for further data in this field especially in real life conditions. METHODS: The SAFARI study is composed of patients with non-valvular atrial fibrillation (AF), previously treated with vitamin K antagonist (VKA) and switched to rivaroxaban...
2016: PloS One
https://www.readbyqxmd.com/read/27917497/acquired-factor-xiii-inhibitor-associated-with-mantle-cell-lymphoma
#15
Christian P Nixon, Elizabeth H Prsic, Christine A Guertin, Ryan L Stevenson, Joseph D Sweeney
BACKGROUND: Acquired Factor (F)XIII deficiency is a very rare bleeding diathesis with a potentially fatal outcome, previously described in the context of autoimmune disorders and leukemias. There is minimal information on autoantibody characterization and the role of antifibrinolytic therapy in patient management. CASE REPORT: A 79-year-old woman with a 3-month history of bruising and heavy menorrhagia presented with ongoing vaginal bleeding, symptomatic anemia, and a right thigh hematoma...
December 4, 2016: Transfusion
https://www.readbyqxmd.com/read/27899993/predictive-value-of-microparticle-associated-tissue-factor-activity-for-permeability-glycoprotein-mediated-multidrug-resistance-in-cancer
#16
Antonio Angelini, Sebastiano Miscia, Maria Antonietta Centurione, Roberta Di Pietro, Lucia Centurione
Multidrug resistance (MDR) protein 1, which is also known as permeability glycoprotein (Pgp), and tissue factor (TF) are recurrently overexpressed on the surface of cancer cells, likely in response to stimuli such as chemotherapy. Microparticles (MPs) released from cancer cells into the bloodstream express tumour markers on their surface that may be useful as predictive biomarkers for evaluating disease progression. The present study measured the level of TF/factor VII (FVII)-dependent coagulation of MPs isolated from the plasma of cancer patients with various tumours, who were undergoing chemotherapy...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27896950/ppar%C3%AE-agonists-negatively-regulate-%C3%AE-iib%C3%AE-3-integrin-outside-in-signalling-and-platelet-function-through-upregulation-of-protein-kinase-a-activity
#17
A J Unsworth, N Kriek, A P Bye, K Naran, T Sage, G D Flora, J M Gibbins
BACKGROUND: Agonists for the peroxisome proliferator activated receptor PPARγ, have been shown to have inhibitory effects on platelet activity following stimulation by GPVI and GPCR agonists. OBJECTIVES: Profound effects on thrombus formation led us to suspect a role for PPARγ agonists in the regulation of integrin αIIbβ3 mediated signalling. Both GPVI and GPCR signalling pathways lead to αIIbβ3 activation, and signalling through αIIbβ3 plays a critical role in platelet function and normal haemostasis...
November 29, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27890816/pathophysiology-of-hemophilic-arthropathy-and-potential-targets-for-therapy
#18
REVIEW
Astrid E Pulles, Simon C Mastbergen, Roger E G Schutgens, Floris P J G Lafeber, Lize F D van Vulpen
Hemophilia is a congenital clotting factor deficiency characterized by spontaneous and trauma-related bleeding. Spontaneous bleeding shows a predilection for joints, and repeated hemarthroses lead to a disabling condition called hemophilic arthropathy. Treatment of this condition consists of preventing joint bleeding on the one hand and orthopedic surgery as a last resort on the other. Up till now, there is no disease modifying therapy available to fill the gap between these extremes. This review provides an overview of the pathogenesis of hemophilic arthropathy in order to identify potential targets for therapy...
January 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27871266/antioxidant-antidiarrheal-hypoglycemic-and-thrombolytic-activities-of-organic-and-aqueous-extracts-of-hopea-odorata-leaves-and-in-silico-pass-prediction-of-its-isolated-compounds
#19
Mohammad Shah Hafez Kabir, Mohammed Munawar Hossain, Md Imtiazul Kabir, Shabbir Ahmad, Nishan Chakrabarty, Md Atiar Rahman, Md Mominur Rahman
BACKGROUND: Hopea Odorata, locally known as Telsur (Bangladesh), has some traditional uses as folk medicine. This study aims to investigate the antioxidant, antidiarrheal, hypoglycemic and thrombolytic activities of H. odorata leaf extracts as new therapeutic prospects predicting the activity of some of the isolated compounds of this plant. METHODS: Leaves of Hopea odorata was extracted with pure methanol (MEHO), ethanol (EEHO) and water (AEHO). The extract was tested for antioxidant activity by using reducing power and H2O2 scavenging assay...
November 21, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27856667/protocolled-redefinition-of-the-therapeutic-range-for-unfractionated-heparin-lost-in-translation
#20
Karlien L M Coene, Fedde van der Graaf, Daan van de Kerkhof
BACKGROUND: Protocolled treatment with unfractionated heparin (UFH) is a subject of ongoing debate. Even though international guidelines prescribe calibration of the activated partial thromboplastin time (aPTT) to 0.3 to 0.7 U/mL anti-Xa activity to establish an UFH therapeutic range, evidence for this approach remains scarce. In this study, we evaluated different strategies to delineate the UFH therapeutic range and analyzed the effects on patient therapeutic classification. METHODS: In 109 patient samples, the aPTT was measured with 2 different reagents, both of which used mechanical clot detection...
November 16, 2016: Clinical and Applied Thrombosis/hemostasis
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