Circulation, Vol 79, 657-665, Copyright © 1989 by American Heart Association
M Heras, JH Chesebro, WJ Penny, KR Bailey, L Badimon and V Fuster
The effect of recombinant hirudin and the dosage of heparin on acute
platelet-thrombus deposition during carotid angioplasty in anesthetized
pigs was prospectively assessed. Fifty-five animals (mean weight, 33.9 kg)
were randomized to one of six heparin dosages: heparin boluses of 35, 50,
100, 150, 200, or 250 units/kg followed by a continuous infusion of 35, 50,
100, 150, 200, or 250 units/kg/hr, respectively. Another five pigs received
a bolus of 1 mg/kg hirudin (recombinant desulphatohirudin), a specific
thrombin inhibitor, followed by an infusion of 1 mg/kg/hr. Bilateral
carotid angioplasty was performed in all pigs 20 minutes after starting the
infusion; they were sacrificed 57 +/- 12 minutes after the procedure. Deep
medial arterial injury was present in approximately 75% of the dilated
segments, and subendothelial injury in the remaining 25%. Mean log of
number of platelets and molecules of fibrinogen per centimeter squared of
deep injury in segments from all the animals treated with heparin were 4.74
+/- 1.03 and 5.02 +/- 0.64, respectively. A regression analysis showed an
inverse correlation of the log of platelet deposition with the heparin
group (r = -0.56, p = 0.0001) with administered total units of heparin (r =
-0.55, p = 0.0003) and with mean plasma heparin concentration (r = -0.55, p
= 0.0004) in deeply injured arteries. Similar inverse relations were
obtained for fibrinogen. In contrast, the deposition of platelets and
fibrinogen in subendothelial injury was very low and independent of the
heparin administered.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Effects of thrombin inhibition on the development of acute platelet- thrombus deposition during angioplasty in pigs. Heparin versus recombinant hirudin, a specific thrombin inhibitor
Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic.
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