PMID- 21773837
OWN - NLM
STAT- MEDLINE
DCOM- 20120315
LR  - 20211020
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 32
IP  - 4
DP  - 2011 Nov
TI  - Comparison of unfractionated heparin, low-molecular-weight heparin, low-dose and 
      high-dose rivaroxaban in preventing thrombus formation on mechanical heart 
      valves: results of an in vitro study.
PG  - 417-25
LID - 10.1007/s11239-011-0621-6 [doi]
AB  - Thromboembolism and bleeding after mechanical heart valve replacement are still 
      unsolved problems, particularly for patients requiring anticoagulative bridging 
      therapy. The aim of this study was to investigate whether rivaroxaban, a new oral 
      selective and direct coagulation factor Xa inhibitor, is as effective as 
      enoxaparin and unfractionated heparin (UFH) in preventing thrombus formation on 
      mechanical heart valves using an in vitro system. Blood from healthy male donors 
      was anticoagulated with either UFH, enoxaparin, rivaroxaban at 300 ng/ml, (n = 10 
      each), or rivaroxaban at 30 ng/ml (n = 3). Mechanical aortic valve prostheses 
      were placed into the in vitro testing system THIA II and exposed to the 
      anticoagulant blood mixtures at a pulsatile flow for 60 min. Overall thrombus 
      weight, coagulation parameters, and electron microscopic features of thrombus 
      formation on the valve surface were quantified as endpoints. The mean thrombus 
      weights were 163 +/- 64 mg for group 1 (UFH), 341 +/- 63 mg for the group 2 
      (enoxaparin), 238 +/- 83 mg for group 3 (rivaroxaban 300 ng/ml) and 1.739 +/- 16 mg 
      for group 4 (rivaroxaban 30 ng/ml). Whereas high-dosed rivaroxaban showed no 
      significant differences compared to UFH or enoxaparin, low-dosed rivaroxaban 
      generated a massive thrombus generation, thus differing significantly from all 
      other treatment groups regarding the thrombus weight. We hypothesize that 
      high-dose rivaroxaban is a competitive oral available alternative to UFH and 
      LMWH's, that might be a worthwhile alternative for patients in need of 
      anticoagulative bridging therapy. Prospective studies have to evaluate if 
      rivaroxaban might even overcome the limitations of OAC in patients after 
      implantation of artificial heart valves.
FAU - Kaeberich, Anja
AU  - Kaeberich A
AD  - Department of Internal Medicine III, Martin Luther-University Halle-Wittenberg, 
      Ernst-Grube-Str. 40, 06120 Halle, Germany.
FAU - Reindl, Iris
AU  - Reindl I
FAU - Raaz, Uwe
AU  - Raaz U
FAU - Maegdefessel, Lars
AU  - Maegdefessel L
FAU - Vogt, Alexander
AU  - Vogt A
FAU - Linde, Torsten
AU  - Linde T
FAU - Steinseifer, Ulrich
AU  - Steinseifer U
FAU - Perzborn, Elisabeth
AU  - Perzborn E
FAU - Hauroeder, Baerbel
AU  - Hauroeder B
FAU - Buerke, Michael
AU  - Buerke M
FAU - Werdan, Karl
AU  - Werdan K
FAU - Schlitt, Axel
AU  - Schlitt A
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Morpholines)
RN  - 0 (Thiophenes)
RN  - 9005-49-6 (Heparin)
RN  - 9NDF7JZ4M3 (Rivaroxaban)
SB  - IM
MH  - Anticoagulants
MH  - Heart Valve Prosthesis/*adverse effects
MH  - Heparin/*pharmacology
MH  - Heparin, Low-Molecular-Weight/*pharmacology
MH  - Humans
MH  - Male
MH  - Models, Biological
MH  - Morpholines/administration & dosage/*pharmacology
MH  - Perfusion
MH  - Rivaroxaban
MH  - Thiophenes/administration & dosage/*pharmacology
MH  - Thrombosis/drug therapy/etiology/*prevention & control
EDAT- 2011/07/21 06:00
MHDA- 2012/03/16 06:00
CRDT- 2011/07/21 06:00
PHST- 2011/07/21 06:00 [entrez]
PHST- 2011/07/21 06:00 [pubmed]
PHST- 2012/03/16 06:00 [medline]
AID - 10.1007/s11239-011-0621-6 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2011 Nov;32(4):417-25. doi: 10.1007/s11239-011-0621-6.