Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.21.6 (thromboplastin)
 13,278 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied the possibility that intravenous nitroglycerin may produce heparin resistance both in vitro and prospectively in a group of 10 patients following coronary angioplasty. Nitroglycerin in physiologic to pharmacologic concentrations (41-250 micrograms/ml) did not produce heparin resistance in vitro as measured by activated partial thromboplastin time and thrombin time. The maximum reduction in activated partial thromboplastin time was 7%. In patient studies, the activated partial thromboplastin time at baseline on heparin alone (93 + 22 s) was not significantly different (p = 0.61) from activated partial thromboplastin measured upon addition of nitroglycerin (94 +/- 27 s) or 30 min following cessation of the nitroglycerin infusion while continuing the same dose of heparin (91 +/- 24 s). We conclude that intravenous nitroglycerin does not induce heparin resistance in vitro or in patients during short-term administration.
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PMID:Does nitroglycerin induce heparin resistance? 252 61

Nitroglycerin has been reported to reduce activated partial thromboplastin time (aPTT) values in patients treated with concurrent heparin and nitroglycerin. However, in vivo studies have yielded conflicting results. In this in vitro evaluation, nitroglycerin was added to samples of pooled plasma from normal volunteers in concentrations of 0, 1, 10, 50, 100, 150, and 200 ng/mL. Preservative-free heparin was then added to the samples to produce final concentrations of 0, 0.3, and 0.6 U/mL. Activated partial thromboplastin time (aPTT) was determined for each sample using a single reagent. There were no significant differences in aPTT values among increasing nitroglycerin concentrations for any of the three levels of heparinization. No direct effect of nitroglycerin on the anticoagulant effect of heparin was observed, as measured by aPTT.
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PMID:Lack of in vitro interaction between heparin and nitroglycerin. 860 10

Nitroglycerin (NTG) reduces the anticoagulant effects of heparin and may lead to heparin resistance. Fresh frozen plasma (FFP) and antithrombin III (ATIII) may be used for the treatment of heparin resistance. We aimed to compare the effects of FFP and ATIII on heparin requirement, coagulation parameters, and bleeding in patients undergoing coronary artery bypass graft surgery (CABGS) with moderate dose of intraoperative NTG infusion. Forty-eight patients undergoing CABGS with NTG infusion were randomly allocated to three groups. Group C served as control, whereas the patients in group P received FFP and those in group A received ATIII after anesthesia induction. ATIII activity and coagulation parameters were measured at five different times intraoperatively. Total heparin requirement, heparin consumption, and heparin sensitivity were calculated. ATIII activity and ACT were significantly higher and activated partial thromboplastin time and fibrinogen level were significantly lower during cardiopulmonary bypass in group A than in groups P and C. Heparin sensitivity was significantly higher and total heparin requirement and consumption were significantly lower in ATIII group than in other groups. ATIII administration increases heparin sensitivity and decreases heparin requirements compared with FFP in patients undergoing CABGS with peroperative NTG infusion. ATIII may be preferred to FFP in patients with heparin resistance due to NTG infusion undergoing CABGS.
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PMID:Peroperative effects of fresh frozen plasma and antithrombin III on heparin sensitivity and coagulation during nitroglycerine infusion in coronary artery bypass surgery. 2179 98