01 March 2004
Gabexate mesilate and heparin responsiveness in coronary patients
Marco RanucciMed Sci Monit 2004; 10(3): PI40-43 :: ID: 11610
Abstract
Background: Heparin responsiveness in patients undergoing coronary operations changes depending on many individual factors. Reduced sensitivity to heparin is a common feature and may determine a difficult intraoperative anticoagulation. The aim of this study was to determine the effectiveness of a novel serine proteases inhibitor (gabexate mesilate) in increasing heparin responsiveness.
Material/Methods: 20 patients undergoing coronary operations with cardiopulmonary bypass were studied with respect to their heparin responsiveness. This was measured using individual dose/response tests with a heparin monitoring system before and after a 10-minute intravenous infusion of 2 mg·kg–1·h–1 of gabexate mesilate, a direct inhibitor of factor Xa, thrombin, kallikrein, and other serine proteases. The complete test was performed before initiating the surgical maneuvers.
Results: At each heparin concentration, gabexate mesilate produced a significant prolongation of the kaolin-activated clotting time. The heparin responsiveness (seconds·IU–1·ml–1) in terms of activated clotting time significantly (p=0.007) increased from the baseline of 68.1±13.8 to 74.7±16.1 during infusion, and the heparin loading dose (IU/kg) required to reach the target activated clotting time of 480 seconds significantly (p=0.009) decreased from the baseline of 290±82.3 to 260±77.6 during gabexate mesilate infusion.
Conclusions: Gabexate mesilate significantly increases individual heparin responsiveness in coronary patients. Its use in the treatment of patients with a reduced sensitivity to heparin may support or replace the conventional therapeutic approach based on fresh frozen plasma or purified antithrombin.
Keywords: Antithrombins - metabolism, Bleeding Time, Blood Coagulation, Coronary Disease - drug therapy, Factor Xa - antagonists & inhibitors, Gabexate - pharmacology, Heparin - metabolism, Heparin - pharmacology, Kallikreins - antagonists & inhibitors, Serine Proteinase Inhibitors - pharmacology, Thrombin - antagonists & inhibitors, Time Factors, Antithrombins - metabolism, Bleeding Time, Blood Coagulation, Coronary Disease - drug therapy, Factor Xa - antagonists & inhibitors, Gabexate - pharmacology, Heparin - pharmacology, Kallikreins - antagonists & inhibitors, Serine Proteinase Inhibitors - pharmacology, Thrombin - antagonists & inhibitors, Time Factors
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
18 Mar 2024 : Clinical Research
Sexual Dysfunction in Women After Tibial Fracture: A Retrospective Comparative StudyMed Sci Monit In Press; DOI: 10.12659/MSM.944136
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
Most Viewed Current Articles
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952