Antithrombin III in patients treated with subcutaneous or intravenous heparin

Conard, J.; Lecompte, Thomas; Horellou, Marie‐Hélène; Cazenave, B.; Samama, M

doi:10.1016/0049-3848(81)90113-4

Cited by 39 publications

(7 citation statements)

References 6 publications

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“…Decreases in antithrombin III have been observed in patients receiving either intravenous or subcutaneous heparin [8,10]. The clinical significance of this observation remains unclear, although some have suggested that this decrease poses a prothrombotic risk [11,12].…”

Section: Discussionmentioning

confidence: 96%

Acquired Antithrombin III Deficiency: Replacement with Antithrombin III Concentrates in a Patient with Protein S Deficiency Accelerates Response to Therapy

Humphries

1993

Acta Haematol

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A 33-year-old man with inherited protein S deficiency and a 20-year history of deep and superficial venous thrombosis was admitted for treatment of extensive, acute, superficial venous thrombosis of the left lower extremity. Clinical response to intravenous heparin was very slow. After discovery of acquired antithrombin III deficiency superimposed on the protein S deficiency, he was given antithrombin III concentrates with the intravenous heparin. His response to therapy was accelerated. The development of acquired antithrombin III deficiency in patients with venous thrombosis may slow the response to standard anticoagulant therapy. Therapy of the thrombosis may be improved with administration of antithrombin III concentrates.

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Section: Discussionmentioning

confidence: 96%

Acquired Antithrombin III Deficiency: Replacement with Antithrombin III Concentrates in a Patient with Protein S Deficiency Accelerates Response to Therapy

Humphries

1993

Acta Haematol

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“…Investigators have reported a progressive reduction in functional and immunologic concentration of AT in patients who had undergone heparin treatment. [102][103][104][105] The Role of Fresh Frozen Plasma Following the demonstration that fresh frozen plasma (FFP) could be used as a source of AT in an AT-deficient patient, Sabbagh et al 106 showed that FFP could "normalize" the heparin-ACT dose-response curve in heparinresistant patients. Barnette and associates 107 examined the effect of FFP on whole blood in vitro, after systemic heparinization, and found it could significantly prolong the ACT but did not prolong the ACT to greater than 400 seconds in three of the six patients who exhibited heparin resistance.…”

Section: Anticoagulation For Cpbmentioning

confidence: 99%

Recombinant Antithrombin: Production and Role in Cardiovascular Disorder

Levy¹,

Weisinger²,

Ziomek³

et al. 2001

Semin Thromb Hemost

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Plasma-derived antithrombin (AT) concentrates have been used for the management of hereditary and acquired deficiencies since the early 1980s. Recombinant versions of other blood factors and their derivatives are increasingly becoming available, providing a safe and abundant supply of these important therapeutics. However, the complexity of the AT molecule and the large doses often required for supplementation treatments preclude the use of traditional cell culture bioreactors for recombinant production. The development of a very efficient expression system has been necessary for the cost-efficient recombinant production of AT. Transgenic production, with its ability to yield high levels of heterologous protein and its scale-up flexibility, is an attractive alternative to plasma fractionation. Purification of recombinant AT from the milk of transgenic dairy goats has been developed to provide a homogeneous, well-defined, and abundant supply of this factor. This article describes the production of recombinant AT and aspects of clinical applications of this molecule to cardiovascular disorders.

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“…[178] The causes of heparin tolerance can be multi-factorial, such as AT III deficiency due to preoperative use of heparin, thrombocytopenia and increased activity of Factor VIII, and it should be previous history of endocarditic and IABP. [789101112] Due to increasing the cardiopulmonary disease and therefore statistical increases of CABG requiring, the importance of heparin tolerance is more visible in CABG. On the other hand by determining the heparin tolerance in a patient, we will be able to be ready for dealing with the consequences of HR.…”

Section: Introductionmentioning

confidence: 99%

“…Heparin tolerance outcomes included death, arrhythmias, bleeding, cardiac arrest, requiring intubation, increasing duration of staying in ICU, increasing the duration of mechanical ventilation. [10] The overall objective of this study was to determine the frequency distribution of heparin tolerance during coronary bypass surgery during the year 2011.…”

Section: Introductionmentioning

confidence: 99%

The evaluations of frequency distribution heparin resistance during coronary artery bypass graft

et al. 2014

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Background:Heparin is one of the most important medication that is used in coronary artery bypass graft (CABG) operations, but some patients demonstrate heparin resistance (HR) during CABG. Heparin resistance was defined as at least one activated clothing time <400 seconds after heparinization and/or the need for purified antithrombin III (AT-III) administration. The goal of this study was the investigation of HR prevalence in our country and relation between HR and post-operative CABG complications.Materials and Methods:One hundred patients that candidate for CABG were selected and surveyed for HR and complications. The data entered to computer and analyzed by SPSS soft ware. The Chi-square and student t-tests were used for data analysis.Results:The prevalence of heparin resistance in our study was 3%. There was no relation among bleeding, cardiac arrest and HR. Bleeding happened in 13 patients of which 1 person was in HR group (33.3%) and 12 in non HR group (12.4%) (P = 0.34). Cardiac arrest happened in 8 patients, 1 person was in HR group (33.3%) and 7 in non HR group (7.2%) (P = 0.22). According our data there were no relation among HR and gender and ventilator dependency time.Conclusions:HR is a nearly prevalent complication among patients that undergone CABG that may led to some complications such as bleeding and cardiac arrest. In our study, we did not find significant relation among them, but in frequency these complications were higher in HR group.

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Antithrombin III in patients treated with subcutaneous or intravenous heparin

Cited by 39 publications

References 6 publications

Acquired Antithrombin III Deficiency: Replacement with Antithrombin III Concentrates in a Patient with Protein S Deficiency Accelerates Response to Therapy

Acquired Antithrombin III Deficiency: Replacement with Antithrombin III Concentrates in a Patient with Protein S Deficiency Accelerates Response to Therapy

Recombinant Antithrombin: Production and Role in Cardiovascular Disorder

The evaluations of frequency distribution heparin resistance during coronary artery bypass graft

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