Guide to Anticoagulant Therapy: Heparin

Hirsh, Jack; Anand, Sonia S.; Halperin, Jonathan L.; Fuster, Valentı́n

doi:10.1161/hq0701.093520

Cited by 85 publications

(56 citation statements)

References 291 publications

(230 reference statements)

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“…Thrombin cleaves fibrinogen-releasing fibrinopeptide A and B and converting fibrinogen into fibrin clot. It is known that heparin requires a plasma cofactor, antithrombin ІІІ (АТ ІІІ), for its anticoagulant activity [14]. АТ ІІІ is the natural inhibitor of thrombin.…”

Section: Tt Assaymentioning

confidence: 99%

Copolymers of 2-acryloylamido-2-methylpropanesulfonic acid and acrylic acid with anticoagulant activity

et al. 2003

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Copolymers of 2-acryloylamido-2-methylpropanesulfonic acid (AMPS) and acrylic acid (AA), as well as the corresponding homopolymers PAMPS and PAA, were studied in vitro on human pool plasma for their anticoagulant activity. The values of the haemostatic parameters -prothrombin time, activated partial thromboplastin time and thrombin time -depend on the composition and the concentration of the (co)polymers. Reptilase time remains unchanged on adding the (co)polymers. A broad concentration range from 16 µg/ml to 3 mg/ml was studied. The copolymers possess anticoagulant activity, which is higher at higher content of AMPS units. It was found that, at certain concentrations, the haemostatic parameters of PAMPS are close to that of heparin. PAA has the lowest anticoagulant activity.

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Section: Tt Assaymentioning

confidence: 99%

Copolymers of 2-acryloylamido-2-methylpropanesulfonic acid and acrylic acid with anticoagulant activity

et al. 2003

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“…The anticoagulant effect of heparin and LMWHs is mediated largely through its direct interaction with antithrombin and heparin cofactor II [13]. Amounting evidence indicates that the release of TFPI from the endothelium contributes to the overall anticoagulant effect of both heparin and LMWHs.…”

Section: Discussionmentioning

confidence: 99%

Molecular weight dependent tissue factor pathway inhibitor release by heparin and heparin oligosaccharides

Töbü

Schultz

et al. 2007

Thrombosis Research

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Heparin and low molecular weight heparins exert their vascular effects by mobilizing tissue factor pathway inhibitor (TFPI) from the vascular endothelium into the blood circulation. We compared the influence of molecular weight on the TFPI release by heparin and its fractions in a non-human primate model. Primates were treated with unfractionated heparin, a low molecular weight heparin (gammaparin), or a heparin-derived oligosaccharide mixture (C3). Endothelial TFPI release was determined using both immunologic and functional assays. After intravenous administration, all agents significantly increased TFPI levels ( p < 0.05) in a dose dependent manner. The increase produced by unfractionated heparin and gammaparin was greater than that by C3 at an equal dosage (p < 0.05). With subcutaneous injection, all agents produced less TFPI release. Repeated administration of heparin-derived oligosaccharides gradually increased TFPI release. A 1.89 fold increase in TFPI levels was observed 4 days after C3 treatment (2.5 mg/ kg). Our findings indicated that TFPI release is dependent on the molecular weight of heparin and its derivatives. Heparin oligosaccharides exert their vascular effects through increased TFPI release after longterm repeated administration.

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“…Heparin and its derivates are often used for prevention and treatment of venous thrombosis, myocardial infarction, and unstable angina 28,29 . Table 1.…”

Section: Heparinmentioning

confidence: 99%

“…The half-life of intravenous heparin ranges from 30 to 150 minutes and its effect can be safely monitored by activated partial thromboplastin time (aPTT) 28,29 . In view of the short half-life of intravenous heparin we propose that heparin should always be interrupted and LP should be performed at least 4 hours after the time of heparin interruption.…”

Section: Intravenous Therapeutic Heparinmentioning

confidence: 99%

Lumbar puncture in patients using anticoagulants and antiplatelet agents

Domingues¹,

Bruniera

Brunale

et al. 2016

Arq. Neuro-Psiquiatr.

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The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

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Guide to Anticoagulant Therapy: Heparin

Cited by 85 publications

References 291 publications

Copolymers of 2-acryloylamido-2-methylpropanesulfonic acid and acrylic acid with anticoagulant activity

Copolymers of 2-acryloylamido-2-methylpropanesulfonic acid and acrylic acid with anticoagulant activity

Molecular weight dependent tissue factor pathway inhibitor release by heparin and heparin oligosaccharides

Lumbar puncture in patients using anticoagulants and antiplatelet agents

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