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Comparison of the hemodynamic and hematologic toxicity of a protamine variant after reversal of low-molecular-weight heparin anticoagulation in a canine model.
Hulin, M S; Wakefield, T W; Andrews, P C; Wrobleski, S K; Kadell, A M; Downing, L J; Stanley, J C.
Afiliación
  • Hulin MS; Unit for Laboratory Animal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
Lab Anim Sci ; 47(2): 153-60, 1997 Apr.
Article en En | MEDLINE | ID: mdl-9150494
Using the dog as an animal model, we developed an experimental preparation to compare hemodynamic and hematologic toxicity of anticoagulation reversal. Currently, protamine sulfate reversal of standard unfractionated heparin and low-molecular-weight heparin (LMWH) anticoagulation causes adverse side effects, including decreased systemic mean arterial pressure (MAP), decreased cardiac output (CO), decreased oxygen consumption (VO2), and thrombocytopenia. In addition, standard protamine is only marginally effective at reversing the factor Xa inhibition induced by LMWHs. We have produced protamine-like variant peptides to decrease the adverse responses attributed to standard protamine. The hemodynamic, hematologic, and coagulation effects of standard protamine and the protamine variant (+18RGD) were assessed after reversal of LMWH anticoagulation in anesthetized dogs. Flow probes and vascular catheters were surgically implanted for measurement of hemodynamic parameters including MAP, CO, VO2, and heart rate (HR). Hematologic studies (platelet and white blood cell counts) and coagulation studies (activated clotting time [ACT], activated partial thromboplastin time [aPTT], thrombin clotting time [TCT], antifactor Xa and antifactor IIa values) also were performed. The protamine variant +18RGD was less toxic, induced less thrombocytopenia, and was more effective in anticoagulation reversal than was standard protamine sulfate. Results of this study indicate that the dog may be a useful model for investigating important hemodynamic, hematologic, and coagulation parameters during reversal of LMWH anticoagulation by use of synthetic protamine variants.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Péptidos / Protaminas / Enfermedades Cardiovasculares / Heparina de Bajo-Peso-Molecular / Modelos Animales de Enfermedad / Enfermedades Hematológicas / Anticoagulantes Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Lab Anim Sci Año: 1997 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Péptidos / Protaminas / Enfermedades Cardiovasculares / Heparina de Bajo-Peso-Molecular / Modelos Animales de Enfermedad / Enfermedades Hematológicas / Anticoagulantes Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Lab Anim Sci Año: 1997 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos