title: Low-intensity oral anticoagulation in sickle-cell disease reverses the prethrombotic state: promises for treatment?
abstract: 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.
authors.affiliation: Slotervaart Municipal Hospital, Department of Internal Medicine, Amsterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Wolters
authors.forename: H
authors.initials: H
authors.lastname: ten Cate
authors.forename: L L
authors.initials: LL
authors.lastname: Thomas
authors.forename: D P
authors.initials: DP
authors.lastname: Brandjes
authors.forename: A
authors.initials: A
authors.lastname: van der Ende
authors.forename: Y
authors.initials: Y
authors.lastname: van der Heiden
authors.forename: L W
authors.initials: LW
authors.lastname: Statius van Eps
mesh_terms: 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*
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D011516:Prothrombin; D013917:Thrombin; D000074:Acenocoumarol