title: Lepirudin dose-dependently increases thrombelastography parameters at therapeutic plasma concentrations as measured with ROTEM® - a pilot study.
abstract: BACKGROUND
  The aim of this in-vitro pilot study was to assess the usefulness of the thrombelastograph ROTEM® for determining the anticoagulant activity of lepirudin.
  
  
  METHODS
  The ROTEM® parameters, clotting-time, clot formation time and maximum clot firmness were measured in the presence of increasing concentrations of lepirudin (10-4 μg/ml - 10 μg/ml). Citrated blood was obtained from 16 healthy male subjects.
  
  
  RESULTS
  Clotting-time increased from 79.1 ± 53.4 s at baseline to 194.1 ± 151.9 s at a drug concentration of 1μg/ml as measured with EXTEM (p < 0.0001). Borderline significance was found for the difference between maximum clot firmness at baseline (60.2 ± 4.3 mm) and after drug application (55.5 ± 6.5 mm).
  
  
  CONCLUSIONS
  This pilot investigation shows that the ROTEM® device may be suitable for monitoring lepirudin at low concentrations but the results should be confirmed in a larger study and the ROTEM® device validated against standard methods.
authors.affiliation: Institute of Experimental and Clinical Pharmacology and Toxicology, University of Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Feuring
authors.forename: M
authors.initials: M
authors.lastname: Wehling
authors.forename: A
authors.initials: A
authors.lastname: Schultz
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000097:blood / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D006629:Hirudins / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011994:Recombinant Proteins / Q000097:blood / Q000494:pharmacology; D013916:Thrombelastography; D014914:Whole Blood Coagulation Time
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; C083544:lepirudin