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  1. Article ; Online: The Use of Tranexamic Acid to Reduce the Need for Nasal Packing in Epistaxis (NoPAC): Randomized Controlled Trial.

    Reuben, Adam / Appelboam, Andrew / Stevens, Kara N / Vickery, Jane / Ewings, Paul / Ingram, Wendy / Jeffery, Alison N / Body, Richard / Hilton, Malcolm / Coppell, Jason / Wainman, Brian / Barton, Andy

    Annals of emergency medicine

    2021  Volume 77, Issue 6, Page(s) 631–640

    Abstract: Study objective: Epistaxis is a common emergency department (ED) presentation and, if simple first aid measures fail, can lead to a need for anterior nasal packing. Tranexamic acid is an agent that contributes to blood clot stability. The aim of this ... ...

    Abstract Study objective: Epistaxis is a common emergency department (ED) presentation and, if simple first aid measures fail, can lead to a need for anterior nasal packing. Tranexamic acid is an agent that contributes to blood clot stability. The aim of this study is to investigate the effectiveness of topical intranasal tranexamic acid in adult patients presenting to the ED with persistent epistaxis, and whether it reduces the need for anterior nasal packing.
    Methods: From May 5, 2017, to March 31, 2019, a double-blind, placebo-controlled, multicenter, 1:1, randomized controlled trial was conducted across 26 EDs in the United Kingdom. Participants with spontaneous epistaxis, persisting after simple first aid and the application of a topical vasoconstrictor, were randomly allocated to receive topical tranexamic acid or placebo. The primary outcome was the need for anterior nasal packing of any kind during the index ED attendance. Secondary outcome measures included hospital admission, need for blood transfusion, recurrent epistaxis, and any thrombotic events requiring any hospital reattendance within 1 week.
    Results: The study sample consisted of 496 participants with spontaneous epistaxis, persisting after simple first aid and application of a topical vasoconstrictor. In total, 211 participants (42.5%) received anterior nasal packing during the index ED attendance, including 111 of 254 (43.7%) in the tranexamic acid group versus 100 of 242 (41.3%) in the placebo group. The difference was not statistically significant (odds ratio 1.107; 95% confidence interval 0.769 to 1.594; P=.59). Furthermore, there were no statistically significant differences between tranexamic acid and placebo for any of the secondary outcome measures.
    Conclusion: In patients presenting to an ED with atraumatic epistaxis that is uncontrolled with simple first aid measures, topical tranexamic acid applied in the bleeding nostril on a cotton wool dental roll is no more effective than placebo at controlling bleeding and reducing the need for anterior nasal packing.
    MeSH term(s) Administration, Intranasal ; Aged ; Antifibrinolytic Agents/therapeutic use ; Bandages ; Double-Blind Method ; Emergency Service, Hospital ; Epistaxis/drug therapy ; Female ; Humans ; Male ; Tranexamic Acid/therapeutic use ; United Kingdom
    Chemical Substances Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
    Language English
    Publishing date 2021-02-19
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/j.annemergmed.2020.12.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Novel use of tranexamic acid to reduce the need for Nasal Packing in Epistaxis (NoPac) randomised controlled trial: research protocol.

    Reuben, Adam / Appelboam, Andrew / Barton, Andy / Vickery, Patricia Jane / Body, Richard / Hilton, Malcolm / Coppell, Jason / Ewings, Paul

    BMJ open

    2019  Volume 9, Issue 2, Page(s) e026882

    Abstract: Introduction: Patients presenting to emergency departments (EDs) with epistaxis uncontrolled by subsequent simple first aid measures or application of topical vasoconstrictors will typically undergo anterior nasal packing. Packing is effective, but can ... ...

    Abstract Introduction: Patients presenting to emergency departments (EDs) with epistaxis uncontrolled by subsequent simple first aid measures or application of topical vasoconstrictors will typically undergo anterior nasal packing. Packing is effective, but can be extremely painful and unpleasant and patients usually need hospital admission. Tranexamic acid (TXA) is a cheap, safe, readily available antifibrinolytic agent known to be beneficial in a variety of clinical settings where uncontrolled bleeding may be a problem. Anecdotal evidence suggests that topical TXA may be of value in persistent epistaxis; however, further evaluation is required.
    Methods and analysis: This is a multicentre, double-blind, parallel group, randomised, controlled trial comparing the use of topical intranasal TXA with indistinguishable placebo in adults presenting to UK EDs with persistent atraumatic epistaxis. Follow-up is at 1 week by structured telephone review. The primary outcome measure is the subsequent need for anterior nasal packing in the ED. Key secondary outcomes include the need for hospital admission, blood transfusion and/or further treatment for epistaxis during the index ED attendance. Recruiting 450 patients will provide 90% power to demonstrate an absolute reduction in packing rate from 95% to 85%. An improvement of this magnitude would be of significant benefit to patients and healthcare providers and justify a change to standard practice. Given the low cost of TXA and its short administration time, a full economic evaluation is not being undertaken.
    Ethics and dissemination: The study has been approved by the South West-Bristol Research Ethics Committee (reference 17/SW/0010). We aim to publish the findings in a high impact, international peer-reviewed journal. Results will also be shared with the Hereditary Haemorrhagic Telangiectasia foundation and telangiectasia UK for dissemination through appropriate related forums.
    Trial registration number: ISRCTN34153772 and EudraCT No: 2016-001530-10.
    MeSH term(s) Administration, Intranasal ; Administration, Topical ; Antifibrinolytic Agents/administration & dosage ; Double-Blind Method ; Emergency Service, Hospital ; Endotamponade/methods ; Epistaxis/drug therapy ; Humans ; Multicenter Studies as Topic ; Randomized Controlled Trials as Topic ; Tranexamic Acid/administration & dosage ; Treatment Outcome
    Chemical Substances Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
    Language English
    Publishing date 2019-02-15
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2018-026882
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: An open-source, expert-designed decision tree application to support accurate diagnosis of myeloid malignancies.

    Coats, Thomas / Bean, Daniel / Vatopoulou, Theodora / Vijayavalli, Dhanapal / El-Bashir, Razan / Panopoulou, Aikaterini / Wood, Henry / Wimalachandra, Manujasri / Coppell, Jason / Medd, Patrick / Furtado, Michelle / Tucker, David / Kulasakeraraj, Austin / Pawade, Joya / Dobson, Richard / Ireland, Robin

    EJHaem

    2021  Volume 2, Issue 2, Page(s) 261–265

    Abstract: Accurate, reproducible diagnoses can be difficult to make in haemato-oncology due to multi-parameter clinical data, complex diagnostic criteria and time-pressured environments. We have designed a decision tree application (DTA) that reflects WHO ... ...

    Abstract Accurate, reproducible diagnoses can be difficult to make in haemato-oncology due to multi-parameter clinical data, complex diagnostic criteria and time-pressured environments. We have designed a decision tree application (DTA) that reflects WHO diagnostic criteria to support accurate diagnoses of myeloid malignancies. The DTA returned the correct diagnoses in 94% of clinical cases tested. The DTA maintained a high level of accuracy in a second validation using artificially generated clinical cases. Optimisations have been made to the DTA based on the validations, and the revised version is now publicly available for use at http://bit.do/ADAtool.
    Language English
    Publishing date 2021-03-26
    Publishing country United States
    Document type Journal Article
    ISSN 2688-6146
    ISSN (online) 2688-6146
    DOI 10.1002/jha2.182
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Ruxolitinib Versus Best Available Therapy for Polycythemia Vera Intolerant or Resistant to Hydroxycarbamide in a Randomized Trial.

    Harrison, Claire N / Nangalia, Jyoti / Boucher, Rebecca / Jackson, Aimee / Yap, Christina / O'Sullivan, Jennifer / Fox, Sonia / Ailts, Isaak / Dueck, Amylou C / Geyer, Holly L / Mesa, Ruben A / Dunn, William G / Nadezhdin, Eugene / Curto-Garcia, Natalia / Green, Anna / Wilkins, Bridget / Coppell, Jason / Laurie, John / Garg, Mamta /
    Ewing, Joanne / Knapper, Steven / Crowe, Josephine / Chen, Frederick / Koutsavlis, Ioannis / Godfrey, Anna / Arami, Siamak / Drummond, Mark / Byrne, Jennifer / Clark, Fiona / Mead-Harvey, Carolyn / Baxter, Elizabeth Joanna / McMullin, Mary Frances / Mead, Adam J

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2023  Volume 41, Issue 19, Page(s) 3534–3544

    Abstract: Purpose: Polycythemia vera (PV) is characterized by JAK/STAT activation, thrombotic/hemorrhagic events, systemic symptoms, and disease transformation. In high-risk PV, ruxolitinib controls blood counts and improves symptoms.: Patients and methods: ... ...

    Abstract Purpose: Polycythemia vera (PV) is characterized by JAK/STAT activation, thrombotic/hemorrhagic events, systemic symptoms, and disease transformation. In high-risk PV, ruxolitinib controls blood counts and improves symptoms.
    Patients and methods: MAJIC-PV is a randomized phase II trial of ruxolitinib versus best available therapy (BAT) in patients resistant/intolerant to hydroxycarbamide (HC-INT/RES). Primary outcome was complete response (CR) within 1 year. Secondary outcomes included duration of response, event-free survival (EFS), symptom, and molecular response.
    Results: One hundred eighty patients were randomly assigned. CR was achieved in 40 (43%) patients on ruxolitinib versus 23 (26%) on BAT (odds ratio, 2.12; 90% CI, 1.25 to 3.60;
    Conclusion: The MAJIC-PV study demonstrates ruxolitinib treatment benefits HC-INT/RES PV patients with superior CR, and EFS as well as molecular response; importantly also demonstrating for the first time, to our knowledge, that molecular response is linked to EFS, PFS, and OS.
    MeSH term(s) Humans ; Polycythemia Vera/drug therapy ; Polycythemia Vera/genetics ; Polycythemia Vera/complications ; Treatment Outcome ; Hydroxyurea/adverse effects ; Nitriles/therapeutic use ; Hemorrhage/complications ; Hemorrhage/drug therapy
    Chemical Substances ruxolitinib (82S8X8XX8H) ; Hydroxyurea (X6Q56QN5QC) ; Nitriles
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Randomized Controlled Trial ; Clinical Trial, Phase II ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.22.01935
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Tamoxifen for the treatment of myeloproliferative neoplasms: A Phase II clinical trial and exploratory analysis.

    Fang, Zijian / Corbizi Fattori, Giuditta / McKerrell, Thomas / Boucher, Rebecca H / Jackson, Aimee / Fletcher, Rachel S / Forte, Dorian / Martin, Jose-Ezequiel / Fox, Sonia / Roberts, James / Glover, Rachel / Harris, Erica / Bridges, Hannah R / Grassi, Luigi / Rodriguez-Meira, Alba / Mead, Adam J / Knapper, Steven / Ewing, Joanne / Butt, Nauman M /
    Jain, Manish / Francis, Sebastian / Clark, Fiona J / Coppell, Jason / McMullin, Mary F / Wadelin, Frances / Narayanan, Srinivasan / Milojkovic, Dragana / Drummond, Mark W / Sekhar, Mallika / ElDaly, Hesham / Hirst, Judy / Paramor, Maike / Baxter, E Joanna / Godfrey, Anna L / Harrison, Claire N / Méndez-Ferrer, Simón

    Nature communications

    2023  Volume 14, Issue 1, Page(s) 7725

    Abstract: Current therapies for myeloproliferative neoplasms (MPNs) improve symptoms but have limited effect on tumor size. In preclinical studies, tamoxifen restored normal apoptosis in mutated hematopoietic stem/progenitor cells (HSPCs). TAMARIN Phase-II, ... ...

    Abstract Current therapies for myeloproliferative neoplasms (MPNs) improve symptoms but have limited effect on tumor size. In preclinical studies, tamoxifen restored normal apoptosis in mutated hematopoietic stem/progenitor cells (HSPCs). TAMARIN Phase-II, multicenter, single-arm clinical trial assessed tamoxifen's safety and activity in patients with stable MPNs, no prior thrombotic events and mutated JAK2
    MeSH term(s) Humans ; Myeloproliferative Disorders/drug therapy ; Myeloproliferative Disorders/genetics ; Myeloproliferative Disorders/pathology ; Janus Kinase 2/genetics ; Janus Kinase 2/metabolism ; Hematopoietic Stem Cells/metabolism ; Signal Transduction ; Neoplasms/metabolism ; Tamoxifen/therapeutic use ; Tamoxifen/metabolism ; Mutation ; Calreticulin/genetics ; Calreticulin/metabolism
    Chemical Substances Janus Kinase 2 (EC 2.7.10.2) ; Tamoxifen (094ZI81Y45) ; Calreticulin
    Language English
    Publishing date 2023-11-25
    Publishing country England
    Document type Clinical Trial, Phase II ; Multicenter Study ; Journal Article
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-023-43175-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Veno-occlusive disease: cytokines, genetics, and haemostasis.

    Coppell, Jason A / Brown, Simon A / Perry, David J

    Blood reviews

    2003  Volume 17, Issue 2, Page(s) 63–70

    Abstract: Hepatic veno-occlusive disease (VOD) is a major cause of morbidity and mortality following high dose cytotoxic therapy for stem cell transplantation (SCT). Pre-existing liver damage, SCT-related therapy, and genetic polymorphisms all appear to increase ... ...

    Abstract Hepatic veno-occlusive disease (VOD) is a major cause of morbidity and mortality following high dose cytotoxic therapy for stem cell transplantation (SCT). Pre-existing liver damage, SCT-related therapy, and genetic polymorphisms all appear to increase the risk of developing VOD. Studies of biological markers during SCT suggest that cytokines, haemostasis, and hepatic drug metabolism via the glutathione pathway are all involved in the pathogenesis of VOD. Until recently, treatment options were limited and experimental therapies directed at the pathogenesis of the disease were mostly unsuccessful. However, Defibrotide, a relatively new agent that has modulatory effects on vascular endothelium, cytokine release, and haemostasis, has been used with some success in the management and prophylaxis of VOD. In the future, a better understanding of genetic polymorphisms and biological markers which may be important in the pathogenesis of VOD, may enable us to predict which patients are most likely to be affected.
    MeSH term(s) Animals ; Cytokines/blood ; Cytokines/genetics ; Hematopoietic Stem Cell Transplantation/adverse effects ; Hemostasis/physiology ; Hepatic Veno-Occlusive Disease/blood ; Hepatic Veno-Occlusive Disease/etiology ; Hepatic Veno-Occlusive Disease/physiopathology ; Humans ; Models, Biological ; Polymorphism, Genetic ; Risk Factors
    Chemical Substances Cytokines
    Language English
    Publishing date 2003-02-25
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 639015-8
    ISSN 1532-1681 ; 0268-960X
    ISSN (online) 1532-1681
    ISSN 0268-960X
    DOI 10.1016/s0268-960x(03)00002-x
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  7. Article: Consider ‘Hyperviscosity Syndrome’ in Unexplained Breathlessness

    Coppell, Jason

    Acta Haematologica

    2000  Volume 104, Issue 1, Page(s) 52–53

    Abstract: A 58-year-old man presenting with increasing shortness of breath over several months is reported here. All investigations were repeatedly normal until he suddenly and rapidly deteriorated, warranting admission, and a diagnosis was made of early multiple ... ...

    Institution Department of Haematology, Queen Mary’s University Hospital, London, UK
    Abstract A 58-year-old man presenting with increasing shortness of breath over several months is reported here. All investigations were repeatedly normal until he suddenly and rapidly deteriorated, warranting admission, and a diagnosis was made of early multiple myeloma associated with the hyperviscosity syndrome. The plasma viscosity was extremely high compared to the low concentration of paraprotein present, and the possible mechanisms are discussed. Although uncommon, the hyperviscosity syndrome is an important cause of dyspnoea which is readily reversible, and should be considered when investigations of cardiac and pulmonary function are normal.
    Keywords Dyspnoea ; Hyperviscosity syndrome ; Multiple myeloma
    Language English
    Publishing date 2000-11-24
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Case Report
    ZDB-ID 80008-9
    ISSN 1421-9662 ; 0001-5792
    ISSN (online) 1421-9662
    ISSN 0001-5792
    DOI 10.1159/000041072
    Database Karger publisher's database

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  8. Article ; Online: Ruxolitinib versus best available therapy for ET intolerant or resistant to hydroxycarbamide in a randomized trial.

    Harrison, Claire N / Mead, Adam J / Panchal, Anesh / Fox, Sonia / Yap, Christina / Gbandi, Emmanouela / Houlton, Aimee / Alimam, Samah / Ewing, Joanne / Wood, Marion / Chen, Frederick / Coppell, Jason / Panoskaltsis, Nicki / Knapper, Steven / Ali, Sahra / Hamblin, Angela / Scherber, Ruben / Dueck, Amylou C / Cross, Nicholas C P /
    Mesa, Ruben / McMullin, Mary Frances

    Blood

    2017  

    Abstract: Treatments for high-risk essential thrombocythemia (ET) address thrombocytosis, disease-related symptoms, as well as risks of thrombosis, hemorrhage, transformation to myelofibrosis and leukemia. Patients resistant/intolerant to hydroxycarbamide (HC) ... ...

    Abstract Treatments for high-risk essential thrombocythemia (ET) address thrombocytosis, disease-related symptoms, as well as risks of thrombosis, hemorrhage, transformation to myelofibrosis and leukemia. Patients resistant/intolerant to hydroxycarbamide (HC) have a poor outlook. MAJIC (ISRCTN61925716) is a randomized phase II trial of ruxolitinib (JAK1/2 inhibitor) vs Best Available Therapy (BAT) in ET and polycythemia vera (PV) patients resistant or intolerant to HC. Here findings of MAJIC-ET are reported, where the modified intention-to-treat population included 58 & 52 patients randomized to receive ruxolitinib or BAT respectively. There was no evidence of improvement in complete response within 1 year reported in 27 (46.6%) patients treated with ruxolitinib vs 23 (44.2%) with BAT (P=.40). At 2 years rates of thrombosis, hemorrhage and transformation were not significantly different, however some disease-related symptoms improved in patients receiving ruxolitinib relative to BAT. Molecular responses were uncommon; there were two complete molecular responses (CMR) and one partial molecular response (PMR) in
    Language English
    Publishing date 2017-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood-2017-05-785790
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Ruxolitinib vs best available therapy for ET intolerant or resistant to hydroxycarbamide.

    Harrison, Claire N / Mead, Adam J / Panchal, Anesh / Fox, Sonia / Yap, Christina / Gbandi, Emmanouela / Houlton, Aimee / Alimam, Samah / Ewing, Joanne / Wood, Marion / Chen, Frederick / Coppell, Jason / Panoskaltsis, Nicki / Knapper, Steven / Ali, Sahra / Hamblin, Angela / Scherber, Robyn / Dueck, Amylou C / Cross, Nicholas C P /
    Mesa, Ruben / McMullin, Mary Frances

    Blood

    2017  Volume 130, Issue 17, Page(s) 1889–1897

    Abstract: Treatments for high-risk essential thrombocythemia (ET) address thrombocytosis, disease-related symptoms, as well as risks of thrombosis, hemorrhage, transformation to myelofibrosis, and leukemia. Patients resistant/intolerant to hydroxycarbamide (HC) ... ...

    Abstract Treatments for high-risk essential thrombocythemia (ET) address thrombocytosis, disease-related symptoms, as well as risks of thrombosis, hemorrhage, transformation to myelofibrosis, and leukemia. Patients resistant/intolerant to hydroxycarbamide (HC) have a poor outlook. MAJIC (ISRCTN61925716) is a randomized phase 2 trial of ruxolitinib (JAK1/2 inhibitor) vs best available therapy (BAT) in ET and polycythemia vera patients resistant or intolerant to HC. Here, findings of MAJIC-ET are reported, where the modified intention-to-treat population included 58 and 52 patients randomized to receive ruxolitinib or BAT, respectively. There was no evidence of improvement in complete response within 1 year reported in 27 (46.6%) patients treated with ruxolitinib vs 23 (44.2%) with BAT (
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Disease Progression ; Drug Resistance ; Female ; Hemorrhage/complications ; Humans ; Hydroxyurea/therapeutic use ; Male ; Middle Aged ; Nitriles ; Pyrazoles/adverse effects ; Pyrazoles/therapeutic use ; Pyrimidines ; Thrombocythemia, Essential/complications ; Thrombocythemia, Essential/drug therapy ; Thrombocythemia, Essential/genetics ; Thrombocythemia, Essential/pathology ; Treatment Outcome ; Withholding Treatment
    Chemical Substances Nitriles ; Pyrazoles ; Pyrimidines ; ruxolitinib (82S8X8XX8H) ; Hydroxyurea (X6Q56QN5QC)
    Language English
    Publishing date 2017-08-09
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood-2017-05-785790
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: The effects of unfractionated heparin, low molecular weight heparin and danaparoid on the thromboelastogram (TEG): an in-vitro comparison of standard and heparinase-modified TEGs with conventional coagulation assays.

    Coppell, Jason A / Thalheimer, Ulrich / Zambruni, Andrea / Triantos, Christos K / Riddell, Anne F / Burroughs, Andrew K / Perry, David J

    Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis

    2006  Volume 17, Issue 2, Page(s) 97–104

    Abstract: To investigate the effects of unfractionated heparin (UFH), low molecular weight heparin (LMWH) and danaparoid (DPD) added to whole blood in vitro on standard and heparinase-modified thromboelastogram (TEG) parameters compared with conventional assays of ...

    Abstract To investigate the effects of unfractionated heparin (UFH), low molecular weight heparin (LMWH) and danaparoid (DPD) added to whole blood in vitro on standard and heparinase-modified thromboelastogram (TEG) parameters compared with conventional assays of coagulation. The effects of UFH, LMWH and DPD on standard TEG parameters were compared with the prothrombin time, activated partial thromboplastin time, thrombin time and anti-activated factor X (anti-FXa) activity, at concentrations of these anticoagulants ranging from 0.025 to 1 U/ml. In the second part of the study, the effects of very low concentrations (0.005-0.05 U/ml) of UFH, LMWH and DPD on the difference between standard and heparinase-modified TEG parameters were compared with the prothrombin time, activated partial thromboplastin time, thrombin time and anti-FXa activity. Standard TEG parameters were outside the reference range at lower concentrations of UFH, LMWH and DPD than most conventional coagulation assays were able to detect. Only anti-FXa activity was more sensitive to the presence of these anticoagulants than the standard TEG alone. The lowest concentration of UFH, LMWH and DPD used in this study (0.005 U/ml) caused significant differences between the standard and heparinase-modified alpha-angles of the TEG. In addition, the difference between standard and heparinase-modified TEG parameters distinguished between low concentrations (0.005-0.05 U/ml) of UFH with greater sensitivity than anti-FXa activity, but were less sensitive to LMWH and DPD. The standard TEG is more sensitive to UFH, LMWH and DPD than most conventional coagulation tests, with the exception of anti-FXa activity. Calculation of the difference between standard and heparinase-modified TEG parameters greatly increases the sensitivity of the assay for the effects of these anticoagulants, and is more sensitive to very low quantities of UFH than anti-FXa activity.
    MeSH term(s) Adult ; Chondroitin Sulfates/chemistry ; Dermatan Sulfate/chemistry ; Factor Xa/analysis ; Heparin Lyase/chemistry ; Heparin, Low-Molecular-Weight/chemistry ; Heparitin Sulfate/chemistry ; Humans ; Male ; Partial Thromboplastin Time/methods ; Reference Standards ; Sensitivity and Specificity ; Thrombelastography/methods
    Chemical Substances Heparin, Low-Molecular-Weight ; Dermatan Sulfate (24967-94-0) ; Chondroitin Sulfates (9007-28-7) ; Heparitin Sulfate (9050-30-0) ; danaparoid (BI6GY4U9CW) ; Factor Xa (EC 3.4.21.6) ; Heparin Lyase (EC 4.2.2.7)
    Language English
    Publishing date 2006-03
    Publishing country England
    Document type Clinical Trial ; Comparative Study ; Journal Article
    ZDB-ID 1033551-1
    ISSN 0957-5235
    ISSN 0957-5235
    DOI 10.1097/01.mbc.0000203859.62739.25
    Database MEDical Literature Analysis and Retrieval System OnLINE

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