Comparison of hirudin and heparin as adjuncts to streptokinase thrombolysis in a canine model of coronary thrombosis.

摘要: Recombinant desulfatohirudin (HI), a potent and specific thrombin inhibitor, was compared with heparin (HE) as an adjunct to streptokinase thrombolysis. In pentobarbital-anesthetized dogs, occlusive thrombus (whole blood+thrombin) introduced into the left anterior descending coronary artery (LAD) superimposed endothelial damage distal high-grade stenosis. Intravenous infusion of saline (vehicle), HI (0.3 mg/kg followed by 0.3 per hour, 1 or 2 hour), HE (60 units/kg 40 hour 100 60 hour) initiated 15 minutes before (750,000 units for minutes) administration. Vessel patency monitored 180 after administration volume flow probe on proximal LAD. dogs treated no adjunctive agent (saline control), none vessels were recanalized streptokinase. Both promoted reperfusion, inhibited reocclusion, reduced residual mass in dose-dependent fashion. However, at comparable levels therapeutic anticoagulation (activated partial thromboplastin time [APTT] = 1.5-2.0 times baseline) exhibited higher incidence reperfusion (eight eight [100%] versus one [12%]), shorter (33 +/- 6 59 minutes), longer duration initial (106 21 10 smaller than did HE. Likewise, slope relation between APTT prolongation total ("anticoagulation/antithrombosis profile") almost five combined data data. Our results indicate that is more effective enhancing sustaining recanalization dose modestly prolongs coagulation does not alter bleeding times.