Point of care measurement of lepirudin and heparin anticoagulation during systemic inflammation.
Thromb Res
; 108(1): 91-5, 2002 Oct 01.
Article
en En
| MEDLINE
| ID: mdl-12586138
ABSTRACT
BACKGROUND:
The number of indications for recombinant human hirudin lepirudin therapy has increased in recent years, and now includes acute coronary syndromes and heparin-induced thrombocytopenia. Hence, point of care monitoring appears desirable for therapy with lepirudin. As CoaguChek Plus (CCP) provides a rapid bedside test to monitor therapy with other anticoagulants, we aimed to determine its suitability for lepirudin therapy.METHODS:
Forty-four healthy volunteers received a 2 ng/kg endotoxin infusion (to induce coagulation) together with clinically relevant doses of lepirudin or heparin in a prospective, placebo-controlled, randomised fashion. Measurements of CCP-partial thromboplastin time (aPTT) were compared to laboratory STA-aPTT.RESULTS:
As expected, baseline values of CCP-aPTT were shorter than STA-aPTT. Lepirudin increased CCP-aPTT 3-fold, and STA-aPTT 2-fold 1 h after bolus infusion. During lepirudin infusion, the correlation between CCP-aPTT and STA-aPTT was excellent (r=0.86-0.92). Both methods were equally sensitive to over-anticoagulation with heparin. Acute systemic inflammation had little effects on CCP-aPTT.CONCLUSION:
CCP-aPTT is suitable for longitudinal point of care monitoring of lepirudin therapy. As baseline values of CCP-aPTT are shorter than STA-aPTT, it is recommended not to indiscriminately change between methods in the follow-up of individual patients.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tiempo de Tromboplastina Parcial
/
Proteínas Recombinantes
/
Heparina
/
Hirudinas
/
Sistemas de Atención de Punto
/
Inflamación
/
Anticoagulantes
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Thromb Res
Año:
2002
Tipo del documento:
Article
País de afiliación:
Austria