Desmopressin antagonizes the in vitro platelet dysfunction induced by GPIIb/IIIa inhibitors and aspirin

Reiter, Rosemarie A.; Mayr, Florian; Blazicek, Hannes; Galehr, Elisabeth; Jilma‐Stohlawetz, Petra; Domanovits, Hans; Jilma, Bernd

doi:10.1182/blood-2002-11-3566

Cited by 130 publications

(78 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Acute release of vWF markedly decreases CT values. 18,28 Thus, the shortened CT values in MI patients could partly be due to increased vWF levels. However, STEMI patients had significantly shorter CT values than did non-STEMI patients, despite similar vWF:RiCO levels (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…18,21 Because different laboratories use different citrate concentrations for sample collection, 21 we determined CT values in blood anticoagulated with either 3.2% or 3.8% citrate. Because CADP-CT was shorter in blood anticoagulated with lepirudin compared with 3.8% citrated blood, 18 we expected shorter CT values at lower citrate concentrations. This was indeed the case (Table 3), but CT values were well correlated between the 2 citrate concentrations (rϭ0.85 and rϭ0.86, PϽ0.0001).…”

Section: Platelet Function Analyzer-100mentioning

confidence: 99%

See 1 more Smart Citation

Platelet Function Predicts Myocardial Damage in Patients With Acute Myocardial Infarction

et al. 2004

Self Cite

View full text Add to dashboard Cite

Background-Platelet activation is a hallmark of acute coronary syndromes. Numerous lines of evidence suggest a mechanistic link between von Willebrand factor or platelet hyperfunction and myocardial damage in patients with acute coronary syndromes. Thus, we assessed whether platelet function under high shear rates (collagen adenosine diphosphate closure times [CADP-CTs]) measured with the platelet function analyzer (PFA-100) may be enhanced in patients with myocardial infarction (MI) and whether it may predict the extent of myocardial damage as measured by creatine kinase (CK-MB) or troponin T (TnT) levels. Methods and Results-Patients with acute chest pain or symptoms suggestive of acute coronary syndromes (nϭ216) were prospectively examined at an emergency department. CADP-CT was significantly shorter in patients with MI, particularly in those with an ST-segment-elevation MI (STEMI) compared with the other patient groups (unstable angina, stable coronary artery disease, or controls). Furthermore, CADP-CT and collagen epinephrine-CT at presentation were independent predictors of myocardial damage as measured by CK-MB or TnT. Patients with MI whose CADP-CT values fell in the first quartile had 3-fold higher CK-MB and TnT levels than those in the fourth quartile. Conclusions-Patients with STEMI have significantly enhanced platelet function when measured under high shear rates.CADP-CT is an independent predictor of the severity of MI, as measured by markers of cardiac necrosis. Measurement of platelet function with the PFA-100 may help in the risk stratification of patients presenting with MI. (Circulation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Platelet Function Analyzer-100mentioning

confidence: 99%

Platelet Function Predicts Myocardial Damage in Patients With Acute Myocardial Infarction

et al. 2004

Self Cite

View full text Add to dashboard Cite

show abstract

“…8,145 Desmopressin acetate, an analog of endogenous vasopressin, has been shown in vitro to antagonize platelet dysfunction induced by glycoprotein IIb/IIIa inhibitors and aspirin. 146 Desmopressin acetate has also been reported to be effective in reducing blood loss after cardiac surgery 147 ; however, subsequent studies failed to show marked benefits in improving perioperative hemostasis. 148 A systematic review showed that desmopressin acetate was able to reduce perioperative blood loss but did not minimize perioperative allogeneic erythrocyte transfusion.…”

Section: Platelet Concentratesmentioning

confidence: 99%

Pathophysiology and Treatment of Coagulopathy in Massive Hemorrhage and Hemodilution

et al. 2010

View full text Add to dashboard Cite

Fluid resuscitation after massive hemorrhage in major surgery and trauma may result in extensive hemodilution and coagulopathy, which is of a multifactorial nature. Although coagulopathy is often perceived as hemorrhagic, extensive hemodilution affects procoagulants as well as anticoagulant, profibrinolytic, and antifibrinolytic elements, leading to a complex coagulation disorder. Reduced thrombin activation is partially compensated by lower inhibitory activities of antithrombin and other protease inhibitors, whereas plasma fibrinogen is rapidly decreased proportional to the extent of hemodilution. Adequate fibrinogen levels are essential in managing dilutional coagulopathy. After extensive hemodilution, fibrin clots are more prone to fibrinolysis because major antifibrinolytic proteins are decreased.Fresh frozen plasma, platelet concentrate, and cryoprecipitate are considered the mainstay hemostatic therapies. Purified factor concentrates of plasma origin and from recombinant synthesis are increasingly used for a rapid restoration of targeted factors. Future clinical studies are necessary to establish the specific indication, dosing, and safety of novel hemostatic interventions.

show abstract

“…15,20,22,37,38 Drugs that inhibit platelet function (e.g., aspirin, clopidogrel) and anticoagulants can unmask or induce mild bleeding problems. Desmopressin improves in vitro hemostatic abnormalities induced by anti-platelet therapies 40 but its effectiveness for treating serious bleeding from these drugs is not yet established. Bleeding from Cushing syndrome and thyroid disease require correction of the endocrine abnormality, whereas bleeding from uremia is often managed by correction of anemia.…”

Section: Commonly Faced Problems In Management Of Mild Bleeding Disormentioning

confidence: 99%

Diagnosis and Management of Mild Bleeding Disorders

Hayward

2005

Hematology

View full text Add to dashboard Cite

Mild bleeding disorders are a common reason for a referral to a hematologist and these conditions can be challenging to evaluate. Recent research has highlighted that some bleeding symptoms are quite common in the general population and that there is clinical variability in symptom expression among individuals with defined bleeding problems. Moreover, bleeding risks for many bleeding disorders are unknown. This article reviews symptoms and problems that can be considered suspicious of a mild form of bleeding disorder and the diagnostic investigations useful to evaluate these problems. A stepwise approach is presented for the diagnostic evaluation, to allow detection of common and rare coagulation and fibrinolytic defects, and adequate assessments of potential von Willebrand factor and platelet problems. Some common problems in the diagnosis and management of mild bleeding problems are reviewed, including the common failure to establish a diagnosis with testing. An approach is proposed for translation of knowledge to patients who are challenged by mild bleeding problems.

show abstract

Desmopressin antagonizes the in vitro platelet dysfunction induced by GPIIb/IIIa inhibitors and aspirin

Cited by 130 publications

References 32 publications

Platelet Function Predicts Myocardial Damage in Patients With Acute Myocardial Infarction

Platelet Function Predicts Myocardial Damage in Patients With Acute Myocardial Infarction

Pathophysiology and Treatment of Coagulopathy in Massive Hemorrhage and Hemodilution

Diagnosis and Management of Mild Bleeding Disorders

Contact Info

Product

Resources

About