title: Recombinant activated coagulation factor VII and prothrombin complex concentrates are equally effective in reducing hematoma volume in experimental warfarin-associated intracerebral hemorrhage.
abstract: OBJECTIVE
  Based on an experimental model of warfarin-associated intracerebral hemorrhage, we investigated whether the rapid reversal of anticoagulation using prothrombin complex concentrates (PCC) or recombinant activated coagulation factor VII (rFVIIa) reduces hematoma volume.
  
  
  METHODS
  Mice were orally pretreated with warfarin (2 mg/kg). Intracerebral hemorrhage was induced by collagenase injection into the right striatum. Forty-five minutes later, PCC (100 IE/kg), rFVIIa (1 mg/kg), or an equal volume of saline was administered intravenously. Hematoma volume after 24 hours was quantified using a photometric hemoglobin assay.
  
  
  RESULTS
  International normalized ratio was 4.3±0.4 in saline-treated mice, 0.9±0.1 in rFVIIa mice, and 1.4±0.2 in PCC mice. Intracerebral hemorrhage volume was 29.0±19.7 μL in the saline group (n=7), 8.6±4.3 μL in the rFVIIa group (n=6), and 6.1±1.8 μL in the PCC group (n=7; analysis of variance between-group differences P=0.004; post hoc rFVIIa versus saline P=0.021; PCC versus saline P=0.007). No significant difference was found between PCC- and rFVIIa-treated animals.
  
  
  CONCLUSIONS
  Our results suggest that PCC and rFVIIa are equally effective in restoring coagulation and preventing excessive hematoma growth in acute warfarin-associated intracerebral hemorrhage.
authors: Department of Neurology, Goethe-University, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany.
authors: Frieder
authors: F
authors: Schlunk
authors: Elizabeth M
authors: EM
authors: Van Cott
authors: Kazuhide
authors: K
authors: Hayakawa
authors: Waltraud
authors: W
authors: Pfeilschifter
authors: Eng H
authors: EH
authors: Lo
authors: Christian
authors: C
authors: Foerch
mesh_terms: D000818:Animals; D001779:Blood Coagulation Factors / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D017364:Collagenases / Q000008:administration & dosage; D005167:Factor VII / Q000494:pharmacology / Q000627:therapeutic use*; D006406:Hematoma / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control*; D006487:Hemostasis; D008297:Male; D051379:Mice; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D001779:Blood Coagulation Factors; C025667:prothrombin complex concentrates; D014859:Warfarin; D005167:Factor VII; D017364:Collagenases