Low-intensity oral anticoagulation in sickle-cell disease reverses the prethrombotic state: promises for treatment?
Increased plasma levels of prothrombin fragment 1 + 2 (F1 + 2) found in patients with sickle-cell disease reflect enhanced endogenous thrombin generation. We postulate that hypercoagulability contributes to vaso-occlusion. The intensity of acenocoumarol treatment required to reduce the F1 + 2 level to 50% of pretreatment level was investigated in seven patients with symptomatic sickle-cell anaemia during steady-state disease for a period of 2 months. All patients had increased levels of F1 + 2 compared with an age-matched control group. Normalization of the F1 + 2 was achieved at a median INR of 1.64 (range 1.18-2.2). It is concluded that low-intensity oral anticoagulation normalizes the hypercoagulability in sickle-cell disease.
Wolters
H J
HJ
Slotervaart Municipal Hospital, Department of Internal Medicine, Amsterdam, The Netherlands.
ten Cate
H
H
Thomas
L L
LL
Brandjes
D P
DP
van der Ende
A
A
van der Heiden
Y
Y
Statius van Eps
L W
LW
D000074:Acenocoumarol / Q000008:administration & dosage*; D000284:Administration, Oral; D000328:Adult; D005260:Female; D006450:Hemoglobin SC Disease / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000378:metabolism; D011498:Protein Precursors / Q000378:metabolism; D011516:Prothrombin / Q000378:metabolism; D013917:Thrombin / Q000378:metabolism*
D010446:Peptide Fragments; D011498:Protein Precursors; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D011516:Prothrombin; D013917:Thrombin; D000074:Acenocoumarol