PMID- 12244483
OWN - NLM
STAT- MEDLINE
DCOM- 20030711
LR  - 20201208
IS  - 0094-6176 (Print)
IS  - 0094-6176 (Linking)
VI  - 28
IP  - 4
DP  - 2002 Aug
TI  - Monitoring of anticoagulant effects of direct thrombin inhibitors.
PG  - 361-8
AB  - Monitoring of direct thrombin inhibitors with the activated partial 
      thromboplastin time (aPTT) is limited by poor linearity and reproducibility. 
      Recently, direct prothrombin activation methods have been developed for 
      coagulation analysis: ecarin clotting time (ECT) and prothrombinase-induced 
      clotting time (PiCT). Laboratory monitoring of the direct thrombin inhibitors 
      lepirudin, argatroban, and melagatran was analyzed and compared with monitoring 
      unfractionated heparin (UFH). Plasma samples of six healthy donors were spiked 
      with lepirudin and argatroban extending to 3000 ng/mL, melagatran extending to 
      1000 ng/mL, and UFH up to 0.48 IU/mL. Clotting times of aPTT (two reagents), ECT, 
      PiCT, and prothrombin time were determined in a KC 10, a micro instrument. At 
      3000 ng/mL ECT values were 339.1 +/- 25.0 seconds with lepirudin and 457.5 +/- 
      29.5 seconds with argatroban. ECT was 586.0 +/- 38.2 seconds with 1000 ng/mL 
      melagatran. The PiCT method provided clotting times of 137.0 +/- 8.4 seconds with 
      UFH, 128.0 +/- 23.4 seconds with lepirudin, and 151 +/- 23.9 seconds with 
      argatroban, and 153.5 +/- 9.9 seconds with melagatran, with the concentrations 
      mentioned. ECT is more sensitive to therapeutic drug concentration ranges than 
      aPTT (prolongations of 3-7 versus 2-3). PiCT yields comparable results with 
      direct thrombin inhibitors and UFH. This method could therefore be suitable for 
      monitoring both drug groups.
FAU - Fenyvesi, Tivadar
AU  - Fenyvesi T
AD  - 4th Department of Medicine, University Hospital, Mannheim, Germany.
FAU - Jorg, Ingrid
AU  - Jorg I
FAU - Harenberg, Job
AU  - Harenberg J
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Semin Thromb Hemost
JT  - Seminars in thrombosis and hemostasis
JID - 0431155
RN  - 0 (Anticoagulants)
RN  - 0 (Azetidines)
RN  - 0 (Benzylamines)
RN  - 0 (Hirudins)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Recombinant Proteins)
RN  - 0 (Sulfonamides)
RN  - 2A9QP32MD4 (melagatran)
RN  - 9005-49-6 (Heparin)
RN  - 94ZLA3W45F (Arginine)
RN  - EC 3.4.21.5 (Thrombin)
RN  - IY90U61Z3S (argatroban)
RN  - TE7660XO1C (Glycine)
RN  - Y43GF64R34 (lepirudin)
SB  - IM
MH  - Anticoagulants/*blood
MH  - Arginine/analogs & derivatives
MH  - Azetidines
MH  - Benzylamines
MH  - Blood Coagulation Tests/methods/standards
MH  - Drug Monitoring/*methods/standards
MH  - Glycine/*analogs & derivatives/blood
MH  - Heparin/blood
MH  - Hirudins/*analogs & derivatives/blood
MH  - Humans
MH  - Pipecolic Acids/blood
MH  - Recombinant Proteins/blood
MH  - Sensitivity and Specificity
MH  - Sulfonamides
MH  - Thrombin/antagonists & inhibitors
EDAT- 2002/09/24 06:00
MHDA- 2003/07/12 05:00
CRDT- 2002/09/24 06:00
PHST- 2002/09/24 06:00 [pubmed]
PHST- 2003/07/12 05:00 [medline]
PHST- 2002/09/24 06:00 [entrez]
AID - 10.1055/s-2002-34305 [doi]
PST - ppublish
SO  - Semin Thromb Hemost. 2002 Aug;28(4):361-8. doi: 10.1055/s-2002-34305.