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Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan.

Publication ,  Journal Article
Tanaka, KA; Szlam, F; Vinten-Johansen, J; Cardin, AD; Levy, JH
Published in: Thromb Haemost
October 2005

Heparin is the current mainstay drug for anticoagulation during cardiac surgery, but it requires normal levels of antithrombin (AT) for optimal anticoagulation. Heparin anticoagulation may be less effective in cardiac surgical patients because of decreased AT levels due to the prolonged heparin therapy. Therefore, other anticoagulants that would work well in AT deficient patients may be more desirable. One such agent currently being evaluated is Intimatan, which catalyzes heparin cofactor II (HCII) dependent inhibition of thrombin. In the current in vitro study we examined the effects of Intimatan (20 microg/ml), heparin (0.25 U/ml), or both drugs in combination on thrombin generation in plasma with decreasing levels of AT, HCII or both cofactors, using a novel method based on the continuous measurement of thrombin generation. For the study, we collected blood samples from healthy volunteers, isolated platelet poor plasma by centrifugation and mixed it with AT, HCII, or AT-HCII deficient plasma samples to achieve different levels of AT, HCII and AT-HCII. Thrombin generation was inhibited equally well with heparin or Intimatan when the level of their respective cofactors was within the normal range. With decreasing levels of AT or HCII, heparin and Intimatan became less effective in thrombin inhibition, respectively. With the absence of both cofactors, neither agent alone or in combination had any effect on thrombin generation. We conclude that Intimatan may be an effective adjunct to heparin therapy under low AT conditions.

Duke Scholars

Published In

Thromb Haemost

DOI

ISSN

0340-6245

Publication Date

October 2005

Volume

94

Issue

4

Start / End Page

808 / 813

Location

Germany

Related Subject Headings

  • Thrombosis
  • Thrombin
  • Prothrombin Time
  • Partial Thromboplastin Time
  • Humans
  • Heparin Cofactor II
  • Heparin
  • Drug Therapy, Combination
  • Dermatan Sulfate
  • Cardiovascular System & Hematology
 

Citation

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Chicago
ICMJE
MLA
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Tanaka, K. A., Szlam, F., Vinten-Johansen, J., Cardin, A. D., & Levy, J. H. (2005). Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan. Thromb Haemost, 94(4), 808–813. https://doi.org/10.1160/TH05-03-0197
Tanaka, Kenichi A., Fania Szlam, Jakob Vinten-Johansen, Alan D. Cardin, and Jerrold H. Levy. “Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan.Thromb Haemost 94, no. 4 (October 2005): 808–13. https://doi.org/10.1160/TH05-03-0197.
Tanaka KA, Szlam F, Vinten-Johansen J, Cardin AD, Levy JH. Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan. Thromb Haemost. 2005 Oct;94(4):808–13.
Tanaka, Kenichi A., et al. “Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan.Thromb Haemost, vol. 94, no. 4, Oct. 2005, pp. 808–13. Pubmed, doi:10.1160/TH05-03-0197.
Tanaka KA, Szlam F, Vinten-Johansen J, Cardin AD, Levy JH. Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan. Thromb Haemost. 2005 Oct;94(4):808–813.
Journal cover image

Published In

Thromb Haemost

DOI

ISSN

0340-6245

Publication Date

October 2005

Volume

94

Issue

4

Start / End Page

808 / 813

Location

Germany

Related Subject Headings

  • Thrombosis
  • Thrombin
  • Prothrombin Time
  • Partial Thromboplastin Time
  • Humans
  • Heparin Cofactor II
  • Heparin
  • Drug Therapy, Combination
  • Dermatan Sulfate
  • Cardiovascular System & Hematology