PMID- 17895513
OWN - NLM
STAT- MEDLINE
DCOM- 20090319
LR  - 20090119
IS  - 1076-0296 (Print)
IS  - 1076-0296 (Linking)
VI  - 15
IP  - 1
DP  - 2009 Feb
TI  - Unfractionated heparin but not enoxaparin causes delayed plasma PAI-1 depletion 
      in hemodialysis patients: a prospective study.
PG  - 84-91
AB  - BACKGROUND AND AIMS: Heparin modulates function of vascular endothelial cells. We 
      studied the effects of unfractionated heparin (UFH) versus low-molecular-weight 
      heparin (LMWH), enoxaparin, used as anticoagulants during hemodialysis (HD) on 
      plasma levels of circulating endothelium-derived molecules: thrombomodulin (TM), 
      von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), cell 
      surface adhesion molecules (E-selectin), intercellular adhesion molecule-1 
      (ICAM-1), and prothrombin fragment 1+2 (PF 1+2). METHODS: Twenty-five patients 
      undergoing enoxaparin-anticoagulated HD were randomly assigned either to continue 
      enoxaparin (n = 13) or receive UFH (n = 12) during HD and followed prospectively 
      for 12 weeks. Plasma immunoreactive TM, vWF, PAI-1, ICAM-1, E-selectin, and PF 
      1+2 were measured before the randomization procedure and after 12 weeks, at the 
      start, after 10 and 180 minutes of HD. RESULTS: The switch from LMWH to UFH 
      resulted in decreased pre-HD levels of PAI-1 and TM and increased PF 1+2 
      concentrations. Predialysis PAI-1 negatively correlated with the total dose of 
      UFH/kg/HD. No significant differences were observed in the other variables before 
      and during HD after switching from LMWH to UFH. During enoxaparin-anticoagulated 
      HD, only plasma PAI-1 levels decreased by 32% after 180 minutes compared with the 
      baseline values. This percentage decrease positively correlated with predialysis 
      PAI-1 levels and marginally with PF 1+2 concentrations after 180 minutes of 
      enoxaparin-anticoagulated HD. CONCLUSION: Enoxaparin-anticoagulated HD is related 
      to transient plasma PAI-1 decrease, whereas UFH anticoagulation may be the cause 
      of delayed PAI-1 and TM depletion, which is an untoward consequence of enhanced 
      coagulation activity in chronic HD patients.
FAU - Naumnik, Beata
AU  - Naumnik B
AD  - Department of Nephrology and Transplantation With Dialysis Unit, Medical 
      University, Bialystok, Poland. bnaumnik@poczta.onet.pl
FAU - Pawlak, Krystyna
AU  - Pawlak K
FAU - Mys'liwiec, Michal
AU  - Mys'liwiec M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20070925
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
RN  - 0 (Anticoagulants)
RN  - 0 (E-Selectin)
RN  - 0 (Enoxaparin)
RN  - 0 (Peptide Fragments)
RN  - 0 (Plasminogen Activator Inhibitor 1)
RN  - 0 (Protein Precursors)
RN  - 0 (Thrombomodulin)
RN  - 0 (von Willebrand Factor)
RN  - 126547-89-5 (Intercellular Adhesion Molecule-1)
RN  - 72270-84-9 (prothrombin fragment 1)
RN  - 78768-79-3 (prothrombin fragment 2)
RN  - 9001-26-7 (Prothrombin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*pharmacology
MH  - E-Selectin/blood
MH  - Enoxaparin/*pharmacology
MH  - Female
MH  - Heparin/*pharmacology
MH  - Humans
MH  - Intercellular Adhesion Molecule-1/blood
MH  - Kidney Failure, Chronic/*blood/therapy
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/blood
MH  - Plasminogen Activator Inhibitor 1/*blood
MH  - Prospective Studies
MH  - Protein Precursors/blood
MH  - Prothrombin
MH  - *Renal Dialysis
MH  - Thrombomodulin/blood
MH  - von Willebrand Factor/analysis
EDAT- 2007/09/27 09:00
MHDA- 2009/03/20 09:00
CRDT- 2007/09/27 09:00
PHST- 2007/09/27 09:00 [pubmed]
PHST- 2009/03/20 09:00 [medline]
PHST- 2007/09/27 09:00 [entrez]
AID - 1076029607304725 [pii]
AID - 10.1177/1076029607304725 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2009 Feb;15(1):84-91. doi: 10.1177/1076029607304725. 
      Epub 2007 Sep 25.