Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Sep 2009
Comparative StudyThe clinical importance of laboratory-defined aspirin resistance in patients presenting with non-ST elevation acute coronary syndromes.
In this study, we aimed to assess the factors associated with laboratory-defined aspirin resistance and the relationship of this laboratory-defined aspirin resistance with thrombolysis in myocardial infarction risk score, markers of cardiac necrosis, and inflammatory and thrombotic risk factors in patients with unstable angina or non-ST elevation myocardial infarction. Ninety-seven patients who were under aspirin therapy and hospitalized with unstable angina/non-ST elevation myocardial infarction were included in the study. Laboratory-defined aspirin sensitive and resistant groups were determined by platelet function analyzer; aspirin resistance was defined as collagen/epinephrine closure time less than 165 s. ⋯ When the details of cardiac myonecrosis markers were compared, baseline and follow-up creatine kinase-myocardial band and troponin I values were higher in laboratory-defined aspirin-resistant group. Multivariate analyses revealed that laboratory-defined aspirin resistance was an independent predictor of non-ST elevation myocardial infarction (P = 0.022). Laboratory-defined aspirin resistance is associated with non-ST elevation myocardial infarction, higher markers of cardiac necrosis and thrombolysis in myocardial infarction risk score in patients hospitalized with unstable angina/non-ST elevation myocardial infarction.
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Blood Coagul. Fibrinolysis · Sep 2009
Comparative StudyEffects of acidosis, alkalosis, hyperthermia and hypothermia on haemostasis: results of point-of-care testing with the thromboelastography analyser.
In this study we assessed the effects of changes in pH, temperature, and their combination in whole blood on thromboelastographic variables. Blood was collected from six healthy volunteers. Thromboelastograph (TEG series 5000; Haemoscope Corporation, Illinois, USA) channels were set at temperatures of 32, 37, and 39 degrees C and each was filled with artificially acidified, alkalified, and neutral blood, respectively. ⋯ Acidosis causes a significant impairment of clot formation and clot strength. Hypothermia had the same effects, but to a lesser extent. These findings emphasize the need for correction of acidosis and hypothermia to normalize haemostasis.
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Blood Coagul. Fibrinolysis · Jul 2009
Case ReportsPerioperative haemostatic management of Glanzmann thrombasthenia for abdominal surgery.
Glanzmann thrombasthenia is a rare congenital platelet disorder characterized by spontaneous mucocutaneous bleeding and severe bleeding complications during major surgery. This report centres on the perioperative haemostatic management of a patient with Glanzmann thrombasthenia undergoing elective major abdominal surgery. ⋯ No red blood cell transfusions were needed perioperatively. For haemostatic monitoring, routine laboratory tests were sufficient.
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Blood Coagul. Fibrinolysis · Jul 2009
Treatment of patients with dysfibrinogenemia and a history of abortions during pregnancy.
Dysfibrinogenemia is caused by a variety of structural abnormalities in the fibrinogen molecule, which results in a tendency for bleeding and thrombosis as well as obstetric complications. The obstetric complications of dysfibrinogenemia include first-trimester pregnancy loss, hemorrhage, placental abruption, and thrombosis. We conducted a retrospective study of four cases of dysfibrinogenemic patients from one family (fibrinogen Frankfurt III) with a history of recurrent pregnancy loss and who were treated with fibrinogen concentrates. ⋯ Fibrinogen was administered from the beginning of the pregnancy until delivery. In three out of four patients, abortions could be avoided by continuous administration of fibrinogen concentrates commencing as early as possible during the pregnancy in order to achieve fibrinogen plasma concentrations (Clauss) over 100 mg/dl. For the prophylaxis of thrombotic events, low-molecular heparin at a dosage of 40-60 IE/kg was administered postpartum for 14 days.
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Blood Coagul. Fibrinolysis · Jul 2009
Carbon monoxide releasing molecule-2 increases the velocity of thrombus growth and strength in human plasma.
Carbon monoxide derived from degradation of heme by heme oxygenase or carbon monoxide releasing molecules (CORMs) has been demonstrated to decrease thrombosis in vivo and to weakly inhibit platelet aggregation. We tested the hypothesis that carbon monoxide released from tricarbonyldichlororuthenium (II) dimer (CORM-2) would diminish the velocity of formation and strength of plasma thrombi as determined by thrombelastography. Normal plasma was exposed to 0 or 100 micromol/l CORM-2 or inactivated CORM-2 (iCORM-2), with coagulation initiated with tissue factor or celite (n = 8 per condition). ⋯ In FXIII deficient plasma CORM-2 significantly increased the velocity of clot formation (264%) and strength (240%). Carbon monoxide and iCORM-2 derived from CORM-2 markedly enhance the velocity of clot growth and strength. These findings serve as the rationale for further investigations to determine if CORMs could be utilized as hemostatic agents.