Effects of antithrombin and gabexate mesilate on disseminated intravascular coagulation: a preliminary study.

Abstract

PURPOSE:

We hypothesized that antithrombin is more effective for disseminated intravascular coagulation (DIC) than is gabexate mesilate, which is a protease inhibitor, suggested from the previous studies. Initially, we compared the effects of antithrombin and gabexate mesilate for treating infection-related DIC.

METHODS:

Sixteen adult patients with a diagnosis of DIC with infection who were assessed with an acute DIC score 4 or higher at the admission to the intensive care unit were divided into antithrombin-treated and gabexate mesilate-treated groups. White blood cell counts, C-reactive protein, platelet counts, antithrombin, fibrin and fibrinogen degradation product, D-dimer, fibrinogen, thrombin antithrombin complex, plasmin plasminogen complex, prothrombin time, and activated partial thrombin time were measured on the day of admission and on days 1, 3, 5, and 7 thereafter. Mortality over 28 days was also compared.

RESULTS:

Platelet counts and antithrombin were significantly higher in the antithrombin group on day 7 and on days 5 and 7, respectively. Antithrombin increased to the normal level on day 1 in the antithrombin group but on day 7 in the gabexate mesilate group. C-reactive protein, fibrinogen degradation product, D-dimer, thrombin antithrombin complex, plasmin plasminogen complex, and prothrombin time were lower in the antithrombin group; but the differences were not significant. The 28-day mortality was 2 of 8 in the antithrombin group and 3 of 8 in the gabexate mesilate group, but they were not significantly different.

CONCLUSIONS:

Antithrombin may be a more effective treatment for coagulation and fibrinolysis disorders than gabexate mesilate in infection-related DIC, but there was no difference in 28-day mortality.

• Authors: Tomoki Nishiyama, Yumiko Kohno, Keiko Koishi
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 30 Issue 7 Pg. 1219-23 (Sep 2012) ISSN: 1532-8171 [Electronic] United States
• PMID: 22204993 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Anticoagulants
• Antithrombins
• Fibrin Fibrinogen Degradation Products
• antithrombin III-protease complex
• fibrin fragment D
• Gabexate
• Antithrombin III
• Fibrinogen
• C-Reactive Protein
• Peptide Hydrolases

Topics

• Adult
• Aged
• Aged, 80 and over
• Anticoagulants (therapeutic use)
• Antithrombin III
• Antithrombins (therapeutic use)
• C-Reactive Protein (analysis)
• Disseminated Intravascular Coagulation (drug therapy)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Fibrinogen (analysis)
• Gabexate (therapeutic use)
• Humans
• Intensive Care Units
• Leukocyte Count
• Male
• Middle Aged
• Partial Thromboplastin Time
• Peptide Hydrolases (blood)
• Platelet Count
• Prothrombin Time
• Single-Blind Method