PMID- 7647223
OWN - NLM
STAT- MEDLINE
DCOM- 19950928
LR  - 20190913
IS  - 0957-5235 (Print)
IS  - 0957-5235 (Linking)
VI  - 6 Suppl 1
DP  - 1995 Jun
TI  - The role of tissue factor pathway inhibitor in the mediation of the 
      antithrombotic actions of heparin and low-molecular-weight heparin.
PG  - S57-64
AB  - It is widely accepted that antithrombin III (ATIII) mediated anti-Xa and anti-IIa 
      effects are the sole determinant of the antithrombotic actions of unfractionated 
      heparin (UFH) and low-molecular-weight heparins (LMWHs). However, there are 
      several unexpected observations such as the greater than 100% bioavailability of 
      subcutaneously administered LMWH as measured by a chromogenic based anti-Xa 
      method. The authors have proposed that, besides ATIII mediated antiprotease 
      actions, additional endogenous factors may be responsible for the observed 
      therapeutic and prophylactic actions of heparins. With the identification of 
      tissue factor pathway inhibitor (TFPI) some of the unexpected effects of heparins 
      can now be clarified. To investigate the role of heparin-releasable TFPI on LMWHs 
      the anti-Xa and TFPI antigen levels after prophylactic and therapeutic 
      administration of UFH and LMWHs have been studied in defined clinical trials. 
      Regardless of the dosage designation (mg/kg or units/kg) each LMWH followed a 
      distinct TFPI release profile. Similarly, in the intravenous studies these LMWHs 
      produced an instantaneous increase in the TFPI antigen level. The anti-Xa effects 
      did not always follow the same pattern as the TFPI antigen levels. These data 
      suggest that the anti-Xa potency of a given LMWH is not the sole determinant of 
      the antithrombotic actions of heparin and LMWH. In addition to pharmacologic 
      agents, the effect of sequential compression devices (SCD) on the release of TFPI 
      was also studied. A two-fold increase in TFPI antigen levels was observed in 
      normal volunteers undergoing long leg compression for 1 h.(ABSTRACT TRUNCATED AT 
      250 WORDS)
FAU - Hoppensteadt, D A
AU  - Hoppensteadt DA
AD  - Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, 
      USA.
FAU - Jeske, W
AU  - Jeske W
FAU - Fareed, J
AU  - Fareed J
FAU - Bermes, E W Jr
AU  - Bermes EW Jr
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Blood Coagul Fibrinolysis
JT  - Blood coagulation & fibrinolysis : an international journal in haemostasis and 
      thrombosis
JID - 9102551
RN  - 0 (Enoxaparin)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Lipoproteins)
RN  - 0 (Nadroparin)
RN  - 0 (Placebos)
RN  - 0 (lipoprotein-associated coagulation inhibitor)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Enoxaparin/pharmacology/therapeutic use
MH  - Factor Xa Inhibitors
MH  - Heparin/*pharmacology
MH  - Heparin, Low-Molecular-Weight/*pharmacology
MH  - Humans
MH  - Kinetics
MH  - Lipoproteins/analysis/metabolism/*physiology
MH  - Nadroparin/therapeutic use
MH  - Placebos
MH  - Thrombophlebitis/prevention & control
EDAT- 1995/06/01 00:00
MHDA- 2001/03/28 10:01
CRDT- 1995/06/01 00:00
PHST- 1995/06/01 00:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1995/06/01 00:00 [entrez]
AID - 10.1097/00001721-199506001-00010 [doi]
PST - ppublish
SO  - Blood Coagul Fibrinolysis. 1995 Jun;6 Suppl 1:S57-64. doi: 
      10.1097/00001721-199506001-00010.