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Prevención de la trombosis arterial rica en plaquetas mediante la inhibición selectiva de la trombina
I K Jang1, H K Gold, A A Ziskind
1Cardiac Unit, Massachusetts General Hospital, Boston 02114.
Circulation
|January 1, 1990
Resumen
La heparina fue ineficaz contra la trombosis arterial en conejos, pero el argatroban, un inhibidor sintético de la trombina, evitó significativamente la formación de coágulos. Esto sugiere que la inhibición selectiva de la trombina es un enfoque prometedor para prevenir la oclusión arterial.
Área de la Ciencia:
- Investigación cardiovascular Investigación cardiovascular Investigación cardiovascular Investigación cardiovascular Investigación cardiovascular
- Farmacología Farmacología.
- Estudios de la trombosis Estudios de la trombosis
Sus antecedentes:
- La trombosis arterial rica en plaquetas es un factor crítico en los eventos cardiovasculares.
- La heparina, un anticoagulante común, tiene limitaciones en la prevención de la trombosis arterial.
- La trombina juega un papel clave en la patogénesis de la trombosis arterial.
Objetivo del estudio:
- Para comparar la eficacia de la heparina y el argatroban en la prevención de la trombosis arterial rica en plaquetas en un modelo de conejo.
- Para investigar el papel de la trombina en la trombosis arterial.
- Evaluar el argatroban como un agente terapéutico potencial para prevenir la oclusión arterial.
Principales métodos:
- Se utilizó un modelo de arteria femoral de conejo con un segmento everteado para inducir la trombosis.
- Animales que recibieron administración intravenosa o intraarterial de heparina o argatroban.
- El desarrollo de la trombosis y la permeabilidad arterial se monitorearon durante 60 minutos y hasta 3 horas después de la infusión.
- Se midió el tiempo de trombina y el tiempo de tromboplastina parcial.
Principales resultados:
- La heparina intravenosa no pudo prevenir la oclusión arterial en todos los conejos.
- El argatroban administrado por vía intravenosa evitó la trombosis en 9 de 13 conejos (p = 0,002 frente a la heparina).
- El argatroban intraarterial fue significativamente más efectivo que la heparina intraarterial, previniendo la trombosis en todos los conejos (p = 0,00001 frente a la heparina).
- Argatroban mantuvo la permeabilidad arterial y mostró una agregación plaquetaria mínima o deposición de fibrina.
Conclusiones:
- La trombina es crucial en la trombosis arterial rica en plaquetas.
- La infusión a corto plazo de argatroban atenúa efectivamente el estímulo trombótico.
- La inhibición selectiva de la trombina ofrece una alternativa potencial para prevenir la oclusión arterial después de la angioplastia o la trombólisis.
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