1992
DOI: 10.1182/blood.v80.4.960.bloodjournal804960
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Sustained antithrombotic activity of hirudin after its plasma clearance: comparison with heparin

Abstract: Thrombus extension in patients with venous thromboembolism is due to the accretion of fibrin onto existing thrombi. Extension is promoted by both circulating and thrombus-bound thrombin, which convert fibrinogen to fibrin. Heparin is an effective antithrombotic agent, but it requires continuous administration to achieve persistent inhibition of thrombus extension. Heparin is highly effective in inhibiting fluid phase thrombin, but is a relatively ineffective inhibitor of thrombus- bound thrombin. Hirudin, unli… Show more

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Cited by 4 publications
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“…15 Moreover, hirudin is highly specific, and acts on both soluble and fibrin-bound thrombin to produce a sustained thrombolytic effect that lasts beyond its plasma clearance. [16][17][18] r-hirudin is relatively small when compared to heparin, 7,8 and thus has the ability to percutaneous penetration following topical application. The antithrombotic effect of topically administered r-hirudin has been clinically assessed in patients with extravasations caused by internal fistula during maintaining-blood purification treatment, a curative effect was observed following a 7-day hirudin cream treatment, with or without ultrashort wave therapy and low-frequency magnetic therapy.…”
Section: Discussionmentioning
confidence: 99%
“…15 Moreover, hirudin is highly specific, and acts on both soluble and fibrin-bound thrombin to produce a sustained thrombolytic effect that lasts beyond its plasma clearance. [16][17][18] r-hirudin is relatively small when compared to heparin, 7,8 and thus has the ability to percutaneous penetration following topical application. The antithrombotic effect of topically administered r-hirudin has been clinically assessed in patients with extravasations caused by internal fistula during maintaining-blood purification treatment, a curative effect was observed following a 7-day hirudin cream treatment, with or without ultrashort wave therapy and low-frequency magnetic therapy.…”
Section: Discussionmentioning
confidence: 99%
“…The accurate measurement of plasma hirudin concentrations by means of a chromogenic assay will not be helpful in monitoring hirudin therapy, as the multicenter study of the HIT Investigators Group [21] in 112 patients showed no correlation between plasma hirudin concentrations and bleeding complications. Agnelli et al [29] found a sustained antithrombotic activity of r-hirudin after its plasma clearance, explaining the divergence between plasma hirudin concentrations and the antithrombotic effect.…”
Section: Discussionmentioning
confidence: 99%
“…These include hirudin, PPACK and other peptides. [7][8][9] Hirudin is a strong inhibitor of both free and clot-bound thrombin and has been used to modify various biomaterials to prevent surface-induced thrombosis. [10][11][12] However, such direct thrombin inhibitors have the disadvantage that their capacity to inhibit thrombin is limited to a single interaction, generally involving formation of a ''tight'' complex.…”
Section: Introductionmentioning
confidence: 99%