title: Drotrecogin alpha: a rational approach to the treatment of submassive pulmonary embolism?
abstract: Combining therapeutic doses of low-molecular-weight heparins and increasing doses of recombinant activated protein C - Drotrecogin alpha (activated), or DAA - is of theoretical interest with regard to the control of coagulation activation. The study by Dempfle and colleagues presents new data showing that endogenous activated protein C levels do not increase in nonseptic patients with pulmonary embolism. However, the results of the addition of these two treatments are puzzling, leaving unresolved the questionable clinical relevance of this combination and the possible increase in bleeding risk.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Hotel-Dieu University Hospital, 1, place du Parvis de Notre-Dame, 75181 Paris Cedex 04, France. marc.samama@htd.aphp.fr
authors.forename: Charles Marc
authors.initials: CM
authors.lastname: Samama
authors.forename: Anne
authors.initials: A
authors.lastname: Godier
mesh_terms: D001777:Blood Coagulation / Q000187:drug effects*; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011486:Protein C / Q000378:metabolism*; D011655:Pulmonary Embolism / Q000188:drug therapy*
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents; D011486:Protein C