Combined administration of protease inhibitor and thromboxane A2 synthetase inhibitor for anticoagulation of a left ventricular assist device.
To establish ideal anticoagulant therapy for left ventricular assist devices (LVADs), a comparative study was made of a thromboxane A2 synthetase inhibitor, a protease inhibitor, and combined administration of the two. Results of the investigation indicate that combined administration of a thromboxane A2 synthetase inhibitor (OKY-046) and a protease inhibitor (nafamostat mesilate, FUT-175) provides ideal anticoagulant therapy during cardiac support using LVADs from the point of blood coagulation and fibrinolysis. Artificial hearts have come into practical use as left ventricular assist devices, and have contributed to the saving of many patients with severe postoperative low cardiac output syndrome, but they sometimes encounter severe complications, i.e. cerebrovascular bleeding, thromboembolism, infection, or multiple organ failure. It is very important, therefore, to control coagulation and fibrinolysis adequately during cardiac support by an LVAD.
Takahama
T
T
1st Dept. of Surgery, Saitama Medical Center, Saitama Medical College, Japan.
Kanai
F
F
Hiraishi
M
M
Onishi
K
K
Yamazaki
Z
Z
Naruse
Y
Y
Furuse
A
A
Yoshitake
T
T
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D001550:Benzamidines; D001780:Blood Coagulation Tests; D004285:Dogs; D004359:Drug Therapy, Combination; D006146:Guanidines / Q000008:administration & dosage; D006353:Heart-Assist Devices; D008689:Methacrylates / Q000008:administration & dosage; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011480:Protease Inhibitors / Q000008:administration & dosage*; D013930:Thromboxane-A Synthase / Q000037:antagonists & inhibitors*
D000925:Anticoagulants; D001550:Benzamidines; D006146:Guanidines; D008689:Methacrylates; D010975:Platelet Aggregation Inhibitors; D011480:Protease Inhibitors; D013930:Thromboxane-A Synthase; C034364:ozagrel; C032855:nafamostat