DOCSLIB.ORG

Investigation of Possible Prophylactic, Renoprotective, and Cardioprotective Effects of Thromboprophylactic Drugs Against Ischemiaereperfusion Injury

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Investigation of Possible Prophylactic, Renoprotective, and Cardioprotective Effects of Thromboprophylactic Drugs Against Ischemiaereperfusion Injury Kaohsiung Journal of Medical Sciences (2015) 31, 115e122 Available online at www.sciencedirect.com ScienceDirect journal homepage: http://www.kjms-online.com ORIGINAL ARTICLE Investigation of possible prophylactic, renoprotective, and cardioprotective effects of thromboprophylactic drugs against ischemiaereperfusion injury Sinan Demirtas a,*, Oguz Karahan a, Suleyman Yazıcı b, Orkut Guclu a, Ahmet Calıskan a, Orhan Tezcan a, Ibrahim Kaplan c, Celal Yavuz a a Medical School of Dicle University, Department of Cardiovascular Surgery, Diyarbakir, Turkey b Istanbul Bilim University, Sisli Florence Nightingale Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey c Medical School of Dicle University, Department of Biochemistry, Diyarbakir, Turkey Received 28 April 2014; accepted 3 October 2014 Available online 13 January 2015 KEYWORDS Abstract The aim of this study was to investigate whether anticoagulant and antiaggregant Antiaggregant drugs; agents have protective effects against oxidative damage induced by peripheral ischemia Anticoagulant drugs; ereperfusion (I/R). Groups were created as follows: control group, I/R group (sham group), Cardioprotection; I/R plus acetylsalicylic acid (Group I), I/Rþclopidogrel (Group II), I/Rþrivaroxaban (Group Ischemiaereperfusion III), I/Rþbemiparin sodium (Group IV), and I/Rþenoxaparin sodium (Group V). In Groups I, injury; II, III, IV, and V, drugs were administered daily for 1 week before I/R creation. Peripheral I/ Renoprotection R was induced in the I/R groups by clamping the right femoral artery. The rats were sacrificed 1 hour after reperfusion. Nitrogen oxide levels, malondialdehyde (MDA) levels, paraoxonase-1 (PON1) activity, and prolidase activity were evaluated in both cardiac and renal tissues. There was no significant difference in nitrogen oxide levels between the groups. However, cardiac and renal MDA were significantly higher and PON1 activity was markedly lower in the I/R groups compared with the control group (p < 0.05). Although elevated prolidase activity was detected in both the cardiac and renal tissue of the I/R groups, only the sham group and Group V had significantly higher renal prolidase activity (p < 0.05). Group V had significantly higher cardiac MDA, PON1, prolidase levels, and renal prolidase activity compared with the sham group (p < 0.05). Significant improvement in renal MDA levels was only observed in Group III, and marked improvement was observed in the cardiac MDA levels of Group II when compared with Conflicts of interest: All authors declare no conflicts of interests. * Corresponding author. Medical School of Dicle University, Department of Cardiovascular Surgery, Diyarbakir, Turkey. E-mail address: [email protected] (S. Demirtas). http://dx.doi.org/10.1016/j.kjms.2014.12.005 1607-551X/Copyright ª 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved. 116 S. Demirtas et al. the sham group (p < 0.05). Thromboprophylactic agents appear to provide partial or prominent protection against I/R injury. Copyright ª 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved. Introduction for this study. The rats were obtained from the Laboratory Animal Production Unit of the university. All rats were Æ Thrombosis can locally obstruct distal flow and cause distal maintained in standard humidity (50 5%) and temperature Æ ischemia or disrupt distant organ perfusion via emboli [1]. (22 2 C) controlled cages with a 12-hour light/dark cycle Therefore, thrombosis prophylaxis regimens for prevention for 1 week prior to the start of the study. of ischemic complications in high-risk populations are frequently investigated [2]. Thrombosis and embolic events Study protocol can occur despite sufficient management and even when appropriate antithrombotic therapy is administered [3]. The rats were randomly divided into seven equal groups. All Treatment for both acute embolic and thrombotic occlusion operations were performed simultaneously on sham and focuses on reperfusion of the ischemic limb. Reducing the study groups for sample standardization. All rats were adverse outcomes of the ischemic injury is also a main anesthetized with ketamine (Ketalarâ; Pfizer, Ta¨by, target of treatment [1]. Furthermore, the duration of Sweden) at a dose of 130 mg/kg and xylazine (Rompunâ; ischemic exposure is an important determinant of tissue Bayer, Gothenburg, Sweden) at a dose of 20 mg/kg via an recovery and of the undesired effects of reperfusion [4,5]. intraperitoneal line. Maintenance of anesthesia was pro- Therefore, receiving prophylaxis prior to thrombosis- vided with ketamine hydrochloride (50 mg/kg). induced ischemia is important. Antiaggregant and anticoagulant agents can be used for Experimental ischemia/reperfusion injury model thromboprophylaxis [6]. Previous investigations of anti- preparation aggregant agents have claimed that these agents modulate The right femoral artery was clamped for 6 hours and then vascular smooth muscle and induce apoptosis, as well as the clamp was removed to create reperfusion. Two millili- inhibit platelet adhesion and aggregation [7]. Previous re- ters of blood samples were obtained from inferior vena ports have also identified antioxidant effects of anti- cava at the 1st hour of reperfusion. The rats were sacrificed aggregant drugs [8]. Similarly, antithrombotic agents have 1 hour after reperfusion, and cardiac tissue samples and cellular effects, on growth factor regulation and cell left kidneys were obtained. adhesion, in addition to preventing new thrombosis for- Eight of the rats were placed in the control group at the mation [9,10]. Previous studies have also mentioned beginning of the study, and 2 mL of blood samples from possible antioxidant features of antithrombotic agents inferior vena cava, cardiac tissue samples, and left kidneys [10,11]. were obtained for determining the baseline nitrogen oxide The purpose of the present study was to investigate and (NOx) levels, malondialdehyde (MDA) levels, and compare the possible cardiac and renal protective effects paraoxonase-1 (PON1) and prolidase activity in blood, of thromboprophylactic agents against ische- renal, and cardiac tissue without any intervention. The miaereperfusion (I/R) injury in an experimental peripheral remaining rats were separated for experimental I/R injury I/R model. induction. The six peripheral I/R injury groups of eight animals Materials and methods each were as follows: Sham group: I/R only. Group I (n Z 8): Acetylsalicylic acid (ASA, Coraspin; All animal procedures were approved by the Animal Bayer, Leverkusen, Germany) was administered orally via Research Committee of Dicle University and were per- gavage at a dose of 30 mg/kg/day beginning 1 week prior to formed in accordance with the Animal Welfare Act and the the start of study. I/R was induced after 1 week of drug Guide for the Care and Use of Laboratory Animals pre- administration. pared by the ethics committee. The principal investigator, Group II (n Z 8): Clopidogrel bisulfate (Planor; Koc¸ak animal laboratory staff, and the primate handling staff Farma, Tekirdag, Turkey) was administered orally via were present for all procedures. Study design and protocol gavage at a dose of 1 mg/kg/day beginning 1 week prior to was created according to our previous experimental the start of the study. I/R was induced after 1 week of drug modeling [12]. administration. Group III (n Z 8): Rivaroxaban (Xarelto; Bayer Schering Animals Pharma AG, Wuppertal, Germany) was administered orally via gavage at a dose of 3 mg/kg/day beginning 1 week prior Fifty-six male SpragueeDawley rats (aged 8e12 weeks) to the start of the study. I/R was induced after 1 week of weighing 230 Æ 30 g (mean Æ standard deviation) were used drug administration. Thrombosis prophylaxis and I/R injury 117 Group IV (n Z 8): Bemiparin sodium (Hibor 3500 IU/ liberated p-nitrophenol at 405 nm and 37C [15]. PON1 0.2 mL; Laboratorios Farmaceuticos Rovi SA, Spain) was activity was expressed as U/L for blood samples and U/g administered intraperitoneally at a dose of 250 U/kg/day protein for tissue extracts. beginning 1 week prior to the start of the study. I/R was induced after 1 week of drug administration. Statistical analysis Group V (n Z 8): Enoxaparin sodium (Oksapar 2000 ANTI- XA IU/0.2 mL; Koc¸ak Farma, Tekirdag, Turkey) was admin- All statistical analyses were performed using SPSS software istered intraperitoneally at a dose of 250 U/kg/day begin- version 15.0 (SPSS Inc., Chicago, IL, USA). All results are ning 1 week prior to the start of the study. I/R was induced expressed as mean Æ standard deviation. Continuous vari- after 1 week of drug administration. ables were compared using one-way analysis of variance (ANOVA). The control group, sham group, and other study groups were compared using the Dunnett test for posthoc Laboratory analysis analysis. A p-value 0.05 was considered statistically significant. Blood samples (2 mL) were obtained from vena cava for evaluating NOx, MDA, PON1, and prolidase levels in plasma. Samples were centrifuged at 4042 g (4000 RPM at 22.6 cm) Results at þ4C for 10 minutes to obtain plasma. Thereafter, plasmas were transferred into Eppendorf tubes. After ani- The blood NOx, MDA, PON1, and prolidase levels were mals were sacrificed, hearts and left kidneys from all 12.1 Æ 3.2mM, 21.4 Æ 19.3mM, 103.5 Æ 89.3 U/L, groups were dissected at 4C and quickly frozen in liquid 102.2 Æ 111.1 U/g in control group, respectively. Changes nitrogen. Tissue was homogenized in 9 mL of 0.25M sucrose in NOx and PON1 levels in sham and study groups were and 10mM EDTA (pH 7.4) using a Teflon homogenizer to found to be insignificant. However, the MDA levels were obtain a 10% suspension, and centrifuged at 3800 Â g for 30 significantly increased in the sham group (155.6 Æ 88.5mM) minutes. Tissue extracts and blood samples were stored at when compared with baseline levels in control group À70C until further analysis.
Load more

Recommended publications
  • Presentación De Powerpoint
    A FAVORABLE DECREASE IN THROMBOCYTE LEVELS CAUSED BY LMWH TREATMENT FOR A DVT PATIENT WITH REFRACTER ESSENTIAL THROMBOCYTOSIS:A case report Hakan Keski, MD, Hematology University of Health Sciences Ümraniye Educaon and Research Hospital, Clinic of Hematology Introducon: Low molecular weightheparins have been found at least as eecve as unfraconed heparin in proximal venous thrombosis and have been shown to further inhibit the in vivo thrombin generaon. Because of the various reasons, there may be some changes among the LMWHs regarding the paent’sclinical follow-ups. Case report: A 53-year-old male paent, paent weight: 88 kg For the paent JAK2 V617F posive essenal thrombocytosis (ET) was diagnosed in Haydarpaa Numune Educaon and Research Hospital in 2006. Paent has been followed in Ümraniye Educaon and Research Hospital the hematology clinic since May 2016. Medical Story (anamnesis): One month nadroparin calcium 3800 IU treatment was given to paent due to lower extremity deep vein thrombosis (DVT) in June 2008.The paent had DVT for the second me in the lower extremity in September 2013, this me enoxaparin sodium 6000 IU was given as treatment. Physical examinaon: Splenomegaly was conrmed with palpaon for 2 cm (168 mm measured with USG) Laboratory: At the me of diagnosis, WBC 10880, Hgb: 15,9 g/dl Hct % 46 Plt: 1820000, biochemical parameters such as urea, creanine, AST, ALT were normal. The paent inially received ASA 100 mg and hydroxyurea 500 mg 3x1 was also given and 3 months later, platelet value was 1750000, the paent has been accepted as refractor and anagrelide treatment has been added with the dossage 2x1, then 3x1 in addion to the current treatment.
    [Show full text]
  • Tanibirumab (CUI C3490677) Add to Cart
    5/17/2018 NCI Metathesaurus Contains Exact Match Begins With Name Code Property Relationship Source ALL Advanced Search NCIm Version: 201706 Version 2.8 (using LexEVS 6.5) Home | NCIt Hierarchy | Sources | Help Suggest changes to this concept Tanibirumab (CUI C3490677) Add to Cart Table of Contents Terms & Properties Synonym Details Relationships By Source Terms & Properties Concept Unique Identifier (CUI): C3490677 NCI Thesaurus Code: C102877 (see NCI Thesaurus info) Semantic Type: Immunologic Factor Semantic Type: Amino Acid, Peptide, or Protein Semantic Type: Pharmacologic Substance NCIt Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor tyrosine kinase expressed by endothelial cells, while VEGF is overexpressed in many tumors and is correlated to tumor progression. PDQ Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor
    [Show full text]
  • Clinical Guidelines Management of Venous Thromboembolism: a Systematic Review for a Practice Guideline Jodi B
    Annals of Internal Medicine Clinical Guidelines Management of Venous Thromboembolism: A Systematic Review for a Practice Guideline Jodi B. Segal, MD, MPH; Michael B. Streiff, MD; Lawrence V. Hofmann, MD; Katherine Thornton, MD; and Eric B. Bass, MD, MPH Background: New treatments are available for treatment of venous tive and safe in carefully chosen patients, with appropriate services thromboembolism. available. Inpatient or outpatient use of LMWH is cost-saving or cost-effective compared with unfractionated heparin. In observa- Purpose: To review the evidence on the efficacy of interventions tional studies, catheter-directed thrombolysis safely restored vein for treatment of deep venous thrombosis (DVT) and pulmonary patency in select patients. Moderately strong evidence supports embolism. early use of compression stockings to reduce postthrombotic syn- drome. Limited evidence suggests that vena cava filters are only Data Sources: MEDLINE, MICROMEDEX, the Cochrane Controlled modestly efficacious for prevention of pulmonary embolism. Con- Trials Register, and Cochrane Database of Systematic Reviews from ventional-intensity oral anticoagulation beyond 12 months may be the 1950s through June 2006. optimal for patients with unprovoked venous thromboembolism, Study Selection: Randomized, controlled trials; systematic reviews although patients with transient risk factors benefit little from more of trials; and observational studies; all restricted to English-language than 3 months of therapy. High-quality trials support use of LMWH articles. in place of oral anticoagulation, particularly in patients with cancer. Little evidence is available to guide treatment of venous thrombo- Data Extraction: Paired reviewers assessed study quality and ab- embolism during pregnancy. stracted data. The authors pooled results about optimal duration of anticoagulation.
    [Show full text]
  • Tumor Angiogenesis
    TUMOR ANGIOGENESIS Edited by Sophia Ran Tumor Angiogenesis Edited by Sophia Ran Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Molly Kaliman Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published February, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from [email protected] Tumor Angiogenesis, Edited by Sophia Ran p.
    [Show full text]
  • ردﺎﺻﻣﻟا BNF 61-2011 a to Z Drugs Fact-2003
    (A to Z drugs©2011) More than 1300 drugs المصادر: BNF 61-2011 A to Z drugs fact-2003 مﻻحظة : يحتوي هذا الجدول باﻻضافة لﻻدوية الى بعض اللقاحات والفيتامينات والمعادن يستخدم هذا الجدول فقط للتعرف على اسماء اﻻدوية واستخداماتها الطبية....ولمزيد من المعلومات راجع المصادر. Generic name Brand name & class& dosage form indications NO. Abacavir ZIAGEN{ Tablets, Oral solution} Treatment of HIV-1 in combination with other antiretroviral agents. 1. Class: Anti-infective, Antiviral ABATACEPT Orencia{ Intravenous infusion} It is licensed for moderate to severe active rheumatoid arthritis in combination with methotrexate, in patients unresponsive to other disease-modifying 2. Antirheumatic, Cytokine Modulators antirheumatic drugs (including methotrexate or a tumour necrosis factor (TNF) inhibitor); It is also licensed for the treatment of moderate to severe active pol articular juvenile idiopathic arthritis(in combination with methotrexate) in children who have not responded adequately to other disease- modifying antirheumatic drugs (including at least one tumour necrosis factor (TNF) inhibitor). Abciximab REOPRO{ Injection} Adjunct to percutaneous coronary intervention (PCI) to prevent ischemic complications in patients at high risk of abrupt closure of the treated vessel. 3. Intended for use with aspirin and heparin. Class: Antiplatelet aluminium oxide Brasivol{ Paste} acne vulgaris 4. ABRASIVE AGENTS acamprosate calcium CAMPRAL{ Tablet} maintenance of abstinence in alcohol dependence. 5. antialcoholic Acarbose PRECOSE, Glucobay{ Tablet} Patients with NIDDM who have failed dietary therapy. May be used alone or in combination with sulfonylureas. 6. Class: Antidiabetic Acebutolol SECTRAL{ Capsules, Tablets} Management of hypertension and premature ventricular contractions. 7. Class: Beta-adrenergic blocker ACECLOFENAC Preservex {Tablets} pain and inflammation in rheumatoid arthritis, osteoarthritis and ankylosing spondylitis 8.
    [Show full text]
  • Heparin-Like Drugs with Antiangiogenic Activity
    1 Heparin-Like Drugs with Antiangiogenic Activity María Rosa Aguilar, Luis García-Fernández, Raquel Palao-Suay and Julio San Román Biomaterials Group, Polymeric Nanomaterials and Biomaterials Department, Institute of Polymer Science and Technology (CSIC), Madrid Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN) Spain 1. Introduction The process of angiogenesis consists in the sprouting of new blood vessels from existing ones. This is a natural process that occurs in the human body and is essential for organ growth and repair. In the embryonic stage, the blood vessels provide the necessary oxygen, nutrients and instructive trophic signals to promote organ morphogenesis (Coultas et al., 2005). After birth the angiogenic process only contributes to organ growth and during adulthood the angiogenic process only occurs in the placenta during the pregnancy and in the cycling ovary, while most blood vessels remain quiescent. However the angiogenic activity could be reactivate because endothelial cells retain their angiogenic activity in response to a physiological stimulus (wound healing and repair) (Alitalo et al., 2005). This angiogenic activity is also critical in the development of solid tumors and metastasis (Ferrara, 2004; Folkman, 1990). Generally, a solid tumor expands until 1-2 mm3 is reached. At this point vascularization is required in order to ensure a supply of nutrients, oxygen, growth factors and proteolytic enzymes to the tumor (Folkman, 1990). To activate the angiogenic activity of endothelial cells, the tumor switches to an angiogenic phenotype and recruits blood vessels from the surrounding tissue, developing a dense vasculature that provides nutrients to the cancerous tissue (Figure 1).
    [Show full text]
  • International Nonproprietary Names (Inn) for Biological and Biotechnological Substances
    INN Working Document 05.179 Distr.: GENERAL ENGLISH ONLY 15/06/2006 INTERNATIONAL NONPROPRIETARY NAMES (INN) FOR BIOLOGICAL AND BIOTECHNOLOGICAL SUBSTANCES (A REVIEW) Programme on International Nonproprietary Names (INN) Quality Assurance and Safety: Medicines (QSM) Medicines Policy and Standards (PSM) Department CONTENTS 0. INTRODUCTION…………………………………….........................................................................................v 1. PHARMACOLOGICAL CLASSIFICATION OF BIOLOGICAL AND BIOTECHNOLOGICAL SUBSTANCES……………………………………................................1 2. CURRENT STATUS OF EXISTING STEMS OR SYSTEMS FOR BIOLOGICAL AND BIOTECHNOLOGICAL SUBSTANCES…………………….3 2.1 Groups with respective stems ……………………………………………………………………3 2.2 Groups with respective pre-stems………………………………………………………………4 2.3 Groups with INN schemes………………………………………………………………………….4 2.4 Groups without respective stems / pre-stems and without INN schemes…..4 3. GENERAL POLICIES FOR BIOLOGICAL AND BIOTECHNOLOGICAL SUBSTANCES……………………………………………………………………………………………………...5 3.1 General policies for blood products……………………………………………………………5 3.2 General policies for fusion proteins……………………………………………………………5 3.3 General policies for gene therapy products………………………………………………..5 3.4 General policies for glycosylated and non-glycosylated compounds………...6 3.5 General policies for immunoglobulins……………………………………………………….7 3.6 General polices for monoclonal antibodies………………………………………………..7 3.7 General polices for skin substitutes……………………………………………………………9 3.8 General policies for transgenic products……………………………………………………9
    [Show full text]
  • (INN) for Biological and Biotechnological Substances
    WHO/EMP/RHT/TSN/2019.1 International Nonproprietary Names (INN) for biological and biotechnological substances (a review) 2019 WHO/EMP/RHT/TSN/2019.1 International Nonproprietary Names (INN) for biological and biotechnological substances (a review) 2019 International Nonproprietary Names (INN) Programme Technologies Standards and Norms (TSN) Regulation of Medicines and other Health Technologies (RHT) Essential Medicines and Health Products (EMP) International Nonproprietary Names (INN) for biological and biotechnological substances (a review) FORMER DOCUMENT NUMBER: INN Working Document 05.179 © World Health Organization 2019 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]
  • Prophylaxis for Venous Thromboembolic Disease in Pregnancy and the Early Postnatal Period (Review)
    Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period (Review) Bain E, Wilson A, Tooher R, Gates S, Davis LJ, Middleton P This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2014, Issue 2 http://www.thecochranelibrary.com Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period (Review) Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 3 OBJECTIVES ..................................... 6 METHODS ...................................... 6 RESULTS....................................... 10 Figure1. ..................................... 12 Figure2. ..................................... 13 DISCUSSION ..................................... 17 AUTHORS’CONCLUSIONS . 18 ACKNOWLEDGEMENTS . 19 REFERENCES ..................................... 19 CHARACTERISTICSOFSTUDIES . 26 DATAANDANALYSES. 57 Analysis 1.1. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 1 Symptomatic thromboembolic events. ...... 60 Analysis 1.2. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 2 Symptomatic pulmonary embolism. 61 Analysis 1.3. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 3 Symptomatic
    [Show full text]
  • Package Leaflet: Information for the User Zibor 2,500 IU Anti-Xa/0.2 Ml Solution for Injection in Pre-Filled Syringes Bemiparin Sodium
    Package leaflet: Information for the user Zibor 2,500 IU anti-Xa/0.2 ml solution for injection in pre-filled syringes Bemiparin sodium Read all of this leaflet carefully before you start using this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. - If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet 1. What Zibor is and what is it used for 2. What you need to know before you use Zibor 3. How to use Zibor 4. Possible side effects 5. How to store Zibor 6. Contents of the pack and other information 1. What Zibor is and what it is used for The active ingredient in Zibor is bemiparin sodium, which belongs to a group of medicines called anticoagulants. These help to stop blood from clotting in the blood vessels. Zibor is used to prevent dangerous blood clots, which have formed in, for example, the veins of the legs and/or the lungs, which can occur if you are undergoing general surgery, and it is also used to prevent blood clots forming in the tubing of the dialysis machine. 2. What you need to know before you use Zibor Do not use Zibor: - if you are allergic to bemiparin sodium or any other ingredients of this medicine (listed in section 6).
    [Show full text]
  • Centre for Reviews and Dissemination
    Low-molecular-weight heparin, bemiparin, in the outpatient treatment and secondary prophylaxis of venous thromboembolism in standard clinical practice: the ESFERA study Santamaria A, Juarez S, Reche A, Gomez-Outes A, Martinez-Gonzalez J, Fontcuberta J, the ESFERA Investigators Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Patients with venous thromboembolism (VTE) were treated as outpatients or inpatients according to doctors' criteria, and all received subcutaneous bemiparin (Hibor; 115 IU/kg) once daily for 7 to 10 days, followed by subcutaneous bemiparin (an oral vitamin K antagonist (VKA) or other) once daily for 3 months according to investigators' criteria. In the primary analysis, outpatient and inpatient cohorts were compared. In the secondary analysis, secondary prophylaxis cohorts were compared (long-term bemiparin versus bemiparin followed by VKA). Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Patients with an acute VTE event who were over 18 years old were included in the study. Patients were excluded if they were hypersensitive to heparin or other pig-derived substances, had a history of documented or suspected immune- mediated heparin-induced thrombocytopaenia (HIT), had an active haemorrhage, had a high risk of bleeding, or severe impairment of liver and pancreas. Further criteria for exclusion were injuries or surgery on the central nervous system, eyes or ears in the last 2 months, intravascular coagulation attributable to HIT, acute or subacute endocarditis, follow-up not possible, pregnancy, end-stage disease or life expectancy of less than 3 months, and participation in another study in the previous month.
    [Show full text]
  • Antiangiogenic Activities of Bemiparin Sodium, Enoxaparin Sodium, Nadroparin Calcium and Tinzaparin Sodium
    Thrombosis Research 128 (2011) e29–e32 Contents lists available at ScienceDirect Thrombosis Research journal homepage: www.elsevier.com/locate/thromres Regular Article Antiangiogenic activities of bemiparin sodium, enoxaparin sodium, nadroparin calcium and tinzaparin sodium Omer Tamer Dogan a, Zubeyde Akin Polat b, Oguz Karahan c, Kursat Epozturk a,⁎, Ahmet Altun d, Ibrahim Akkurt a, Ali Cetin e a Department of Chest Diseases, Cumhuriyet University School of Medicine, Sivas, Turkey b CUTFAM Research Center, Cumhuriyet University School of Medicine, Sivas, Turkey c Department of Cardiovascular Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey d Department of Pharmacology, Cumhuriyet University School of Medicine, Sivas, Turkey e Department of Obstetric and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey article info abstract Article history: Introduction: The low-molecular-weight heparins have been demonstrated to have antiangiogenic effects in Received 6 September 2010 various assays. We aimed to demonstrate and compare the antiangiogenic effects of four types of commercially Received in revised form 8 April 2011 available low-molecular weight heparins in the chick embryo chorioallantoic membrane model. Accepted 3 May 2011 Materials and methods: The antiangiogenic efficacies of bemiparin, enoxaparin, nadroparin, and tinzaparin were Available online 24 May 2011 examined in vivo in the chick chorioallantoic membrane model. Drug solutions are prepared in three different concentrations (100 IU, 10 IU, or 1 IU/10 μl). For each set of experiment twenty fertilized eggs were used. The Keywords: decrease of vessel formation is examined and scored according to previous literature. Angiogenesis Chick chorioallantoic membrane model Results: Bemiparin, enoxaparin, nadroparin, and tinzaparin sodium all have antiangiogenic effects on chick Low-molecular-weight heparins chorioallantoic membrane at the concentration of 100 IU/10 μl.
    [Show full text]