PMID- 15034156
OWN - NLM
STAT- MEDLINE
DCOM- 20040921
LR  - 20061115
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 19
IP  - 6
DP  - 2004 Jun
TI  - Attenuation of platelet reactivity by enoxaparin compared with unfractionated 
      heparin in patients undergoing haemodialysis.
PG  - 1559-63
AB  - BACKGROUND: Increased platelet reactivity presages adverse cardiac events. 
      Because both haemodialysis and unfractionated heparin (UFH) can increase platelet 
      reactivity, we compared platelet reactivity during haemodialysis when patients 
      were anticoagulated with UFH or enoxaparin. METHODS: Patients (n = 20) underwent 
      consecutive haemodialysis sessions with either UFH or enoxaparin in a random 
      order. Blood was taken from the arterial end of the haemodialysis circuit at the 
      initiation of haemodialysis before anticoagulation. Subsequently, blood was taken 
      during dialysis from the venous end of the circuit 10 min after treatment with 
      UFH or enoxaparin. Platelet reactivity was assessed with the use of flow 
      cytometry by determining the capacity of platelets to bind fibrinogen and the 
      surface expression of P-selectin in response to adenosine diphosphate (ADP, 0 and 
      0.2 microM). Results were compared with the use of two-way repeated measure 
      ANOVA. RESULTS: Platelet reactivity in arterial blood obtained at the beginning 
      of dialysis prior to patients being treated with either UFH [0.2 microM 
      ADP-induced capacity to bind fibrinogen = 28+/-15% (SD)] or enoxaparin (30+/-18%) 
      was similar (P = 0.15). In contrast, platelet reactivity was less after treatment 
      with enoxaparin compared with UFH (P = 0.006). The 0.2 microM ADP-induced 
      capacity to bind fibrinogen in venous blood obtained 10 min after anticoagulation 
      was 34+/-11% after treatment with UFH and 22+/-11% after treatment with 
      enoxaparin. CONCLUSIONS: Anticoagulation with enoxaparin during haemodialysis is 
      associated with less platelet reactivity compared with UFH. Accordingly, 
      enoxaparin use may contribute to a lesser risk of cardiac events in patients with 
      end-stage renal disease treated with haemodialysis.
FAU - Aggarwal, Atul
AU  - Aggarwal A
AD  - Department of Medicine, University of Vermont College of Medicine, Burlington, 
      VT, USA. vipulatul7@yahoo.com
FAU - Whitaker, Deborah A
AU  - Whitaker DA
FAU - Rimmer, Jeffrey M
AU  - Rimmer JM
FAU - Solomon, Richard J
AU  - Solomon RJ
FAU - Gennari, F John
AU  - Gennari FJ
FAU - Sobel, Burton E
AU  - Sobel BE
FAU - Schneider, David J
AU  - Schneider DJ
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20040319
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (P-Selectin)
RN  - 9001-32-5 (Fibrinogen)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*pharmacology
MH  - Blood Platelets/*drug effects
MH  - Enoxaparin/*pharmacology
MH  - Female
MH  - Fibrinogen/metabolism
MH  - Flow Cytometry
MH  - Heparin/*pharmacology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - P-Selectin/analysis
MH  - Platelet Activation/*drug effects
MH  - Protein Binding
MH  - *Renal Dialysis
EDAT- 2004/03/23 05:00
MHDA- 2004/09/24 05:00
CRDT- 2004/03/23 05:00
PHST- 2004/03/23 05:00 [pubmed]
PHST- 2004/09/24 05:00 [medline]
PHST- 2004/03/23 05:00 [entrez]
AID - gfh209 [pii]
AID - 10.1093/ndt/gfh209 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2004 Jun;19(6):1559-63. doi: 10.1093/ndt/gfh209. Epub 
      2004 Mar 19.