PMID- 20174756
OWN - NLM
STAT- MEDLINE
DCOM- 20100617
LR  - 20201209
IS  - 2567-689X (Electronic)
IS  - 0340-6245 (Linking)
VI  - 103
IP  - 4
DP  - 2010 Apr
TI  - The direct thrombin inhibitor argatroban effectively prevents cardiac catheter 
      thrombosis in vitro.
PG  - 808-14
LID - 10.1160/TH09-07-0456 [doi]
AB  - The direct thrombin inhibitor argatroban offers some significant advantages over 
      unfractionated heparin (UFH) and is recommended as an alternative anticoagulant 
      during percutaneous coronary interventions (PCI). The impact of argatroban on 
      cardiac catheter thrombosis--a severe potential complication of PCI--has not been 
      systematically studied yet. The aim of the present study was to test in vitro the 
      hypothesis that argatroban is equivalent to the more established anticoagulants 
      UFH and enoxaparin in preventing catheter thrombus formation. Blood pretreated 
      with the anticoagulants of interest was continuously circulated through a guiding 
      catheter by using a roller pump for a maximum experimental period of 60 minutes. 
      In an alternate model, coagulation was mechanically induced by a magnetic 
      stirrer. Coagulation parameters, overall thrombus weight and electron microscopic 
      features (deposits of platelets and fibrin on the catheter surface) were 
      quantified as endpoints. Argatroban (administered as bolus or continuous 
      infusion), UFH (bolus), and enoxaparin (bolus) significantly reduced catheter 
      thrombus formation compared to untreated controls. Here, neither overall thrombus 
      weight nor platelet/fibrin deposition was different among the specific 
      anticoagulants. Declining ACT (activated clotting time) levels--which were found 
      in the argatroban bolus group--could be prevented by continuous infusion. In 
      magnetic stirrer-induced coagulation, thrombus weight was lower following bolus 
      treatment with UFH and enoxaparin compared to argatroban. These data suggest that 
      the potential for argatroban in preventing catheter thrombosis is comparable to 
      that of UFH and enoxaparin. However, the anticoagulatory efficacy varied, 
      depending on the model of coagulation activation, which demonstrates the 
      necessity for specific testing.
FAU - Raaz, Uwe
AU  - Raaz U
AD  - Department of Medicine III, Martin-Luther-University, Ernst-Grube-Str. 40, 06097 
      Halle, Germany. uwe.raaz@medizin.uni-halle.de
FAU - Kaeberich, Anja
AU  - Kaeberich A
FAU - Maegdefessel, Lars
AU  - Maegdefessel L
FAU - Buerke, Michael
AU  - Buerke M
FAU - Busshardt, Marese
AU  - Busshardt M
FAU - Schubert, Sebastian
AU  - Schubert S
FAU - Russ, Martin
AU  - Russ M
FAU - Plehn, Alexander
AU  - Plehn A
FAU - Ebelt, Henning
AU  - Ebelt H
FAU - Werdan, Karl
AU  - Werdan K
FAU - Schlitt, Axel
AU  - Schlitt A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100219
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Sulfonamides)
RN  - 0 (antithrombin III-protease complex)
RN  - 9000-94-6 (Antithrombin III)
RN  - 9001-31-4 (Fibrin)
RN  - 9005-49-6 (Heparin)
RN  - 94ZLA3W45F (Arginine)
RN  - EC 3.4.- (Peptide Hydrolases)
RN  - EC 3.4.21.5 (Thrombin)
RN  - EC 3.4.21.6 (Factor Xa)
RN  - IY90U61Z3S (argatroban)
SB  - IM
MH  - Anticoagulants/*pharmacology
MH  - Antithrombin III
MH  - Arginine/analogs & derivatives
MH  - Blood Coagulation/*drug effects
MH  - Blood Platelets/drug effects/metabolism
MH  - *Cardiac Catheterization/adverse effects/instrumentation
MH  - Enoxaparin/pharmacology
MH  - Factor Xa/metabolism
MH  - Factor Xa Inhibitors
MH  - Fibrin/metabolism
MH  - Heparin/pharmacology
MH  - Humans
MH  - Male
MH  - Peptide Hydrolases/blood
MH  - Pipecolic Acids/*pharmacology
MH  - Stress, Mechanical
MH  - Sulfonamides
MH  - Thrombin/*antagonists & inhibitors/metabolism
MH  - Thrombosis/blood/etiology/*prevention & control
MH  - Time Factors
EDAT- 2010/02/23 06:00
MHDA- 2010/06/18 06:00
CRDT- 2010/02/23 06:00
PHST- 2009/07/14 00:00 [received]
PHST- 2009/12/13 00:00 [accepted]
PHST- 2010/02/23 06:00 [entrez]
PHST- 2010/02/23 06:00 [pubmed]
PHST- 2010/06/18 06:00 [medline]
AID - 09-07-0456 [pii]
AID - 10.1160/TH09-07-0456 [doi]
PST - ppublish
SO  - Thromb Haemost. 2010 Apr;103(4):808-14. doi: 10.1160/TH09-07-0456. Epub 2010 Feb 
      19.