PMID- 12679128
OWN - NLM
STAT- MEDLINE
DCOM- 20040120
LR  - 20190727
IS  - 0049-3848 (Print)
IS  - 0049-3848 (Linking)
VI  - 109
IP  - 1
DP  - 2003 Jan 1
TI  - Hemostatic markers with bolus versus prolonged heparin after carotid artery 
      stenting.
PG  - 23-9
AB  - BACKGROUND: The evolving technique of carotid stenting (CS) requires optimal 
      antithrombotic strategies to reduce periinterventional thromboembolic risk. In 
      animal models of balloon injury, tissue factor (TF) was shown to be the major 
      procoagulant of the atherosclerotic plaque mediating prolonged procoagulant 
      activity. METHODS: We analyzed TF and TF-dependent hemostatic markers before and 
      2, 6 and 24 h after CS with two antithrombotic drug regimens. Group A (n=20) 
      received prolonged unfractionated heparin (UFH) for 18-20 h starting at 
      intervention next to aspirin and thienopyridine. In group B (n=16), single bolus 
      UFH was administered next to combined antiplatelet therapy. Natural 
      anticoagulants were determined at baseline. RESULTS: Patients with symptomatic 
      and asymptomatic cerebrovascular disease did not differ in plasma TF levels. 
      Furthermore, no statistically significant difference for TF, TFPI/Xa-complex and 
      prothrombin fragment F1.2 was observed between bolus and prolonged heparin 
      treatment. No significant change was found in time course for these parameters. 
      Two patients (5.5%; one in each treatment group) suffered periinterventional 
      minor stroke associated with increased levels of F1.2 and TFPI/Xa-complex. Both 
      were resistant to activated protein C (APC ratio<1.9) due to heterozygous factor 
      V Leiden mutation. CONCLUSIONS: No significant activation of the TF pathway was 
      seen with both antithrombotic regimens suggesting that single bolus UFH combined 
      with antiplatelet therapy is generally sufficient to control TF-dependent 
      procoagulant activity after CS. However, patients with resistance to activated 
      protein C may be at increased periinterventional stroke risk.
FAU - Steiner, Sabine
AU  - Steiner S
AD  - Division of Angiology, 2nd Department of Internal Medicine, General Hospital, 
      University of Vienna, Wahringer Gurtel 18-20, A-1090 Vienna, Austria. 
      sabine.steiner@univie.ac.at
FAU - Ahmadi, Ramazanali
AU  - Ahmadi R
FAU - Willfort, Andrea
AU  - Willfort A
FAU - Lang, Wilfried
AU  - Lang W
FAU - Huber, Kurt
AU  - Huber K
FAU - Minar, Erich
AU  - Minar E
FAU - Kopp, Christoph W
AU  - Kopp CW
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anticoagulants)
RN  - 0 (Biomarkers)
RN  - 0 (Lipoproteins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (lipoprotein-associated coagulation inhibitor)
RN  - 0 (prothrombin fragment 1.2)
RN  - 9001-26-7 (Prothrombin)
RN  - 9005-49-6 (Heparin)
RN  - 9035-58-9 (Thromboplastin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/administration & dosage
MH  - Biomarkers/blood
MH  - Carotid Artery Diseases/blood/*therapy
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hemostasis/*drug effects
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Lipoproteins/blood
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/blood
MH  - Platelet Aggregation Inhibitors/administration & dosage
MH  - Prothrombin
MH  - Stents/*adverse effects
MH  - Thromboplastin/*analysis
MH  - Time Factors
EDAT- 2003/04/08 05:00
MHDA- 2004/01/21 05:00
CRDT- 2003/04/08 05:00
PHST- 2003/04/08 05:00 [pubmed]
PHST- 2004/01/21 05:00 [medline]
PHST- 2003/04/08 05:00 [entrez]
AID - S0049384803001403 [pii]
AID - 10.1016/s0049-3848(03)00140-3 [doi]
PST - ppublish
SO  - Thromb Res. 2003 Jan 1;109(1):23-9. doi: 10.1016/s0049-3848(03)00140-3.