Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effectiveness of two different heparin types in preventing deep vein thrombosis after surgery was studied in 173 patients, randomly assigned to treatment by a new low molecular weight (LMWH) heparin or trade calcium heparin (CH). Both drugs were administered subcutaneously, 2 h before surgery and for 7 days after, at dose of 7,500 anti activated factor X Units once a day in low molecular weight heparin group, or 5,000 International Units t.i.d. in calcium heparin group. Both activated factor X inhibition and activated partial thromboplastin time evaluations were performed before the surgery, and 3 and 7 days after, to monitor drug effects. Results clearly demonstrated that low molecular weight heparin exerts a marked inhibition on plasma activated factor X. On the contrary, calcium heparin was less powerful in inhibiting this coagulation factor. Both drugs revealed a lower effectiveness in increasing activated partial thromboplastin time. Efficacy in preventing postoperative thrombo-embolism appeared about 3 times higher for the new low molecular weight heparin, despite the lower daily administration numbers. No major side effects related to drug were observed in both treatment groups; also hemorrhage frequency was the same. No differences related to the operation type were found in preventive actions of both drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prevention of postoperative deep vein thrombosis by two different heparin types. 284 66

In a prospective clinical study heparin half-life and in vitro and ex vivo heparin sensitivity, as assessed by activated partial thromboplastin time prolongation, was evaluated in 8 healthy volunteers and in 21 patients with malignant tumor. In the patients, coagulation activation was evaluated by determining the fibrinogen half-life and the level of the fibrin-fibrinogen degradation products. The results were comparable in the two groups of subjects, and in the patients there was no correlation with the degree of activation of the coagulation system. In both groups large interindividual variations were recorded. These results confirm those obtained in patients with deep venous thrombosis. They suggest that the relative heparin resistance phenomenon encountered in some patients during heparin therapy is unrelated to the presence of the thromboembolic disease (P.M.).
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PMID:[The phenomenon of relative resistance to heparin]. 295 73

Sixty-eight patients with acute deep vein thrombosis were allocated at random to two treatment groups. One group (n = 33) received a fixed dose of 750 anti-Xa units of a low molecular weight heparin (CY 222 Choay Institute); the other group (n = 35) received standard heparin in doses of 500 IU/kg/24 h. Both treatments were given for 10 days in two daily subcutaneous injections. A second phlebography was performed on the last day of treatment. No haemorrhagic complication was observed in the group treated with CY 222, as opposed to three cases of haemorrhage in the group treated with standard heparin. The initial phlebographic score and the location of deep vein thrombotic lesions were the same in both groups. Angiographic improvement, with more than 30% thrombolysis, was obtained at the end of treatment in 64% of patients in the CY 222 group and in 65% of patients in the standard heparin group (NS). In 2 patients treated with standard heparin the second phlebography showed extension of the thrombosis. The initial score remained unchanged in 1/3 of patients in both groups. The activated partial thromboplastin time was prolonged (2 or 3 fold the normal value) in the standard heparin group and unchanged in the CY 222 group. Anti-Xa activity was significantly higher in the CY 222 group than in the standard heparin group. It is concluded that CY 222 and standard heparin were equally effective in patients with deep vein thrombosis. However, haemorrhagic complications were more frequent with standard heparin that with CY 222.
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PMID:[A new treatment of deep venous thrombosis: low molecular weight heparin fractions. Randomized study]. 296 75

Intravenous heparin is the initial treatment of choice for most patients with acute pulmonary embolism or proximal deep vein thrombosis. The primary objective of initial heparin therapy in such patients is to prevent recurrent venous thromboembolism. The efficacy of intravenous heparin for this purpose has been established by randomized clinical trials in patients with pulmonary embolism, and more recently, in patients with proximal vein thrombosis. Heparin is given as an initial intravenous bolus of 5000 units, followed by a maintenance dose of 30,000-40,000 units per 24 h by continuous intravenous infusion. A recent randomized trial in patients with proximal vein thrombosis indicates that failure to achieve an adequate anticoagulant response (APTT greater than 1.5 times control) is associated with a high risk (25%) of recurrent venous thromboembolism. Intravenous heparin administered in doses that prolong the activated partial thromboplastin time (APTT) to 1.5 or more times the control value is highly effective, and associated with a low frequency (2%) of recurrent venous thromboembolism. Heparin is continued for 7-10 days, overlapped with warfarin sodium during the last 4-5 days. Multiple randomized clinical trials indicate that this approach is highly effective. An alternative approach is to commence heparin and oral anticoagulants together at the time of diagnosis, and to discontinue heparin on the fourth or fifth day. A recent randomized trial in patients with submassive venous thrombosis or pulmonary embolism suggests that 4-5 days of initial heparin therapy is effective and safe, but this approach must be evaluated by further randomized trials before it is recommended for patients with extensive proximal vein thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heparin therapy for venous thrombosis and pulmonary embolism. 306 31

This open controlled study compared the effects of subcutaneous administration of two types of heparin in two groups of 40 patients each with deep vein thrombosis. One group received calcium heparin and the other received low molecular weight heparin for 40 days in each case. Patients receiving low molecular weight heparin showed a greater increase in inhibition of activated factor X than those receiving calcium heparin. Both drugs slightly reduced activated partial thromboplastin time. No patient experienced pulmonary embolism during the study. At the end of the study, maximum venous outflow was significantly higher in patients given low molecular weight heparin than in those given calcium heparin. No major side-effects were observed. This study showed that: (a) the anti-thrombotic effect of low molecular weight heparin was greater than for calcium heparin; and (b) low molecular weight heparin improved maximum venous outflow in approximately half of the patients, possibly by promoting or accelerating recanalization of the vessel.
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PMID:Deep vein thrombosis of the legs: new therapy by means of low molecular weight heparins. 306 22

Antithrombotic activity, necessary doses and effects on coagulation and lipid variables of the low molecular weight heparin derivative Fragmin were compared to unfractionated (UF) heparin in long-term multicentre trials. Results of more than 10,000 dialyses are reported. On the basis of preliminary studies, UF heparin and Fragmin doses were used that lead to anti-Xa activities of more than 0.5 U/ml. With this dose, sufficient antithrombotic activity was achieved with both heparins. Bleeding complications were not noticed. Partial thromboplastin time (PTT) and thrombin time were only marginally increased by Fragmin (5-8 s) in contrast to UF heparin (PTT 90-120 s, thrombin time 230-260 s). Surprisingly, the elevated levels of factor VIII strongly decreased during the 6-month treatment period with Fragmin and increased again during the following 6-month treatment period with UF heparin. Creatinine, urea, haemoglobin and transaminases did not change in both heparin groups: this excluded reduced dialysis efficiency or occult blood loss. Additionally, 15 patients with acute renal failure and high bleeding risk were dialysed with low doses of Fragmin (anti-FXa: 0.2-0.3 U/ml). No severe bleeding occurred. A continuous ambulant peritoneal dialysis patient with deep vein thrombosis was treated effectively with intraperitoneal application of Fragmin for 6 months without any problems.
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PMID:Comparison of unfractionated heparin and low molecular weight heparin during long-term use in chronic haemodialysis and haemofiltration patients. 309 59

A lupus inhibitor paradoxically prolongs phospholipid-dependent coagulation assays, but may increase risk of thromboembolism. We studied seven patients with cerebral infarcts and one with TIA who had lupus inhibitor. The average age at onset of cerebral ischemia was 41 years. Three patients had multiple cerebral ischemic events. The activated partial thromboplastin time was longer than that of controls, but usually within normal limits. Other abnormalities included biologic false-positive VDRL, antinuclear antibodies, thrombocytopenia (three patients each), and deep vein thrombosis (two patients).
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PMID:Cerebral infarct, TIA, and lupus inhibitor. 309 32

Lupus anticoagulant, an immunoglobulin that prolongs the partial thromboplastin time, has been associated with thrombotic events, including deep venous thrombosis, pulmonary emboli, and Budd-Chiari syndrome. In this report, primary sclerosing cholangitis was diagnosed in a man with a 10-year history of multiple thrombotic events related to a circulating lupus anticoagulant. Progressive jaundice and pruritus developed, and sclerosing cholangitis was confirmed by direct cholangiography. Sclerosing cholangitis is the second hepatobiliary disease reported in association with a lupus anticoagulant.
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PMID:Primary sclerosing cholangitis in the presence of a lupus anticoagulant. 309 67

Intravenous fat tolerance was tested in two groups of patients given a continuous i.v. infusion of heparin for several days. One group of 11 patients with deep vein thrombosis (DVT) of the leg was given 25,000-35,000 IU heparin daily for 4-5 days. The other group comprised 10 patients who had central venous catheters (CVC) for total parenteral nutrition. These patients were given 20,000 IU heparin daily for 6 days as prophylaxis against CVC-related thrombosis. In the DVT group heparinization was associated with a 44% decrease in plasma fat removal capacity (P less than 0.05). This reduction persisted for 2 days after the discontinuation of heparin therapy. In the CVC group the plasma fat removal capacity decreased by 29% during heparinization (P greater than 0.05, NS). During heparinization activated partial thromboplastin time was more than three times the basal value in the DVT group but less than twice those in the CVC group. One week after the heparin therapy the serum triglyceride levels were higher in both groups compared with initial values (DVT group: 1.2 +/- 0.2 s.e. mean vs. 1.7 +/- 0.3 mmol/l; P less than 0.05. CVC group: 1.0 +/- 0.1 vs. 1.4 +/- 0.2 mmol/l; NS). The possibility that full-dose heparinization reduces plasma fat removal capacity and that this may be due to a partial depletion of lipoprotein lipase stores is discussed.
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PMID:Plasma clearance of fat emulsion during continuous heparin infusion. 310 29

A prospective study was carried out to see whether a small fixed dose of warfarin (1 mg daily) given before operation (mean 20 days) would prevent deep vein thrombosis in patients having major gynaecological surgery. One hundred and four patients were randomised into three groups: fixed minidose warfarin; full dose oral anticoagulation; and no treatment (controls). There was a significantly lower incidence of deep vein thrombosis in the minidose warfarin and full dose anticoagulant treatment groups (9% (3/32) and 3% (1/35) respectively) than in the controls (30%; 11/37) but no significant difference between the two anticoagulant treatment groups. Prothrombin time and the activated partial thromboplastin time were normal on the day of surgery in the warfarin treatment group, whereas times were prolonged in the group given full dose anticoagulation. Mean haemoglobin concentrations fell in all three groups after operation but the fall was significantly less in the minidose warfarin treatment group than after full dose anticoagulation. The benefit from full dose oral anticoagulant prophylaxis, based on a preoperative international normalised ratio of 1.5-2.5 with rabbit brain Manchester reagent, was similar to the protection achieved in an oral anticoagulant treatment group controlled with human brain Manchester comparative reagent at a similar level of anticoagulation. The lack of disturbance of normal haemostasis at the time of operation together with a significant reduction in deep vein thrombosis may encourage surgeons to introduce minidose prophylaxis with warfarin.
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PMID:Fixed minidose warfarin: a new approach to prophylaxis against venous thrombosis after major surgery. 312 Sep 89


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