Recombinant activated coagulation factor VII and prothrombin complex concentrates are equally effective in reducing hematoma volume in experimental warfarin-associated intracerebral hemorrhage.

Abstract

BACKGROUND AND PURPOSE:

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: Frieder Schlunk, Elizabeth M Van Cott, Kazuhide Hayakawa, Waltraud Pfeilschifter, Eng H Lo, Christian Foerch
• Journal: Stroke (Stroke) Vol. 43 Issue 1 Pg. 246-9 (Jan 2012) ISSN: 1524-4628 [Electronic] United States
• PMID: 21998055 (Publication Type: Journal Article)

Chemical References

• Blood Coagulation Factors
• prothrombin complex concentrates
• Warfarin
• Factor VII
• Collagenases

Topics

• Animals
• Blood Coagulation Factors (pharmacology, therapeutic use)
• Brain (drug effects, pathology)
• Cerebral Hemorrhage (chemically induced, drug therapy, pathology)
• Collagenases (administration & dosage)
• Factor VII (pharmacology, therapeutic use)
• Hematoma (chemically induced, drug therapy, pathology, prevention & control)
• Hemostasis
• Male
• Mice
• Treatment Outcome
• Warfarin (administration & dosage)