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Nicholas Moore - One of the best experts on this subject based on the ideXlab platform.
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effect of traditional uyghur medicine abnormal savda munziq extract on rabbit platelet aggregation in vitro and rat arteriovenous Shunt Thrombosis in vivo
Journal of Ethnopharmacology, 2015Co-Authors: Anwar Umar, Nicholas Moore, Wuliya Yimin, Ibadet Tohti, Halmurat Upur, Benedicte BerkeAbstract:Abstract Objective Abnormal Savda Munziq (ASMq) is a standard herbal preparation used in Uyghur traditional medicine to fight chronic diseases including cardiovascular, but its specific effects on Thrombosis and platelet aggregation are unknown. Methods Rabbit platelets were incubated with ASMq extract (10, 20, 40 µg/ml) for 15, 30, or 60 min, and aggregation was induced with ADP and collagen. In vivo, ASMq extract 2.97 g/kg, 5.94 g/kg, 11.88 g/kg per os daily for 15 days were tested on thrombus wet weight in a rat model of arterio-venous bypass Thrombosis. Plasma thromboxane B2 (TXB 2 ) and 6-keto-PGF1a (6PG) were measured by radioimmunoassay. Aspirin (12 µg/ml and 5 mg/kg) and saline were used as control in both experiments. Results ASMq inhibited ADP and collagen-induced aggregation in vitro in a dose-dependent manner that increased over time, to a maximum of 6.4±1.3% and 21.6±4.0% for ADP and collagen, respectively, at one hour׳s incubation with the highest concentration, whereas the effects of aspirin (34.5±2.2% and 41.9±2.5%, respectively) were stable over time. In vivo, ASMq inhibited thrombus formation dose-dependently, by 70% at the highest dose, compared to 67% with aspirin. ASMq essentially did not change prostaglandin production, compared to the clear inhibition by aspirin. Conclusion Abnormal Savda Munziq extract inhibits dose-dependent platelet aggregation with ADP or collagen in vitro and Thrombosis in vivo to values similar to those of aspirin, though unlike aspirin this effect does not seem mediated by an inhibition of cyclo-oxygenase.
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effect of armagnac fractions on human platelet aggregation in vitro and on rat arteriovenous Shunt Thrombosis in vivo probably not related only to polyphenols
Thrombosis Research, 2007Co-Authors: Najim Al A Awwadi, Anne Borrotbouttefroy, Anwar Umar, Cedric Saucier, Marieclaude Segur, Charles Garreau, Mireille Canal, Yves Glories, Nicholas MooreAbstract:Abstract Previous studies showed that alcohol-free extracts of Armagnac, an oak cask aged spirit rich in polyphenols, inhibit human platelet function in vitro and in vivo, in an experimental rat arteriovenous Shunt Thrombosis model and in human healthy volunteers. To identify active compounds, we fractionated a freeze-dried extract of a 10-year-old Armagnac using successively chloroform, diethyl ether and ethyl acetate. The 4 resulting fractions were tested on in vitro human platelet aggregation induced by ADP and in vivo on arteriovenous Shunt Thrombosis after 10 days oral treatment in rats. Active components were found mainly in fractions 1 and 3: at the highest concentration (2.4 10 − 2 g/l), in vitro ADP-induced aggregation was inhibited by 62.7 ± 2.1% and 51.2 ± 3.8% for F1 and F3, respectively, vs 18.9 ± 2.4% and 13.9 ± 0.4% for fractions 2 and 4 and 33.6 ± 1.5% for the crude extract. There was a significant decrease in thrombus weight with the crude extract and all fractions tested after 10 days treatment with 2.5 mg/kg/day orally, greatest with fraction 1. Characterisation of phenol content showed that fraction 1, the most biologically active, was essentially devoid of ellagic acid and ellagitannins, the polyphenols initially thought responsible for the effect, whereas fraction 2 which was mostly inactive, was the richest in polyphenols. Conclusion The antiplatelet and antithrombotic activity of Armagnac seems mostly unrelated to polyphenols.
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aqueous extracts of ocimum basilicum l sweet basil decrease platelet aggregation induced by adp and thrombin in vitro and rats arterio venous Shunt Thrombosis in vivo
Thrombosis Research, 2006Co-Authors: Ibadet Tohti, Anwar Umar, Maynur Tursun, Subat Turdi, Horyat Imin, Nicholas MooreAbstract:Objective To study the effects of aqueous extract of Ocimum basilicum L (OBL) on platelet aggregation and experimental thrombus. Methods Platelet aggregation induced by ADP (5 μM) and thrombin (4 UI), and thrombus weight in an arteriovenous Thrombosis (AVT) model were tested after 2 weeks treatment with 15, 75 and 375 mg/kg OBL orally in rats, compared to 8.8 mg/kg/day aspirin. AVT was also tested 2 h after 75 mg/kg OBL orally, after 3 and 7 days treatment, and one, three and seven days after the end of a two-week treatment. Analysis was done by ANOVA followed by protected t-tests (Tukey). Results OBL (15, 75, 375 mg/Kg) dose-dependently inhibits platelet aggregation by ADP and thrombin, with 75 mg/kg/day having approximately the same effect as 8.8 mg/kg/day aspirin. ADP induced aggregation reached 45%, 28% and 18% for OBL, respectively, 15, 75, 375 mg/kg compared to 71% for control and 27% for aspirin (all p < 0.01 except aspirin vs. OBL 75 mg/kg/day p = 0.7). Thrombin-induced aggregation reached 33%, 22%, 21% for OBL, respectively, 15, 75, 375 mg/kg compared to 67% for control and 48% for aspirin (all p < 0.01 except OBL 75 vs. OBL 375 mg/kg/day, p = 1.0). Compared to a control thrombus weight of 48.1 mg (SD 4.9), thrombus weight was 29.4 (3.3), 19.0 (1.9) and 12.3 (1.7) after treatment for 2 weeks with 15, 75 and 375 mg/kg OBL, respectively, and 27.4 (5.3) after 8.8 mg/kg aspirin (all p < 0.001 except aspirin vs. OBL 75 mg/kg/day p = 1.0). Maximum effect of OBL was reached after one week's treatment. The effect subsided between 3 and 7 days. Conclusion OBL possesses an inhibitory effect on platelet aggregation induced by ADP and thrombin, that is dose-dependent and results in an anti-thrombotic effect in vivo which develops progressively over 7 days and disappears over 3–7 days. The active ingredient now needs to be characterized.
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effects of armagnac extracts on human platelet function in vitro and on rat arteriovenous Shunt Thrombosis in vivo
Thrombosis Research, 2003Co-Authors: Anwar Umar, Charles Garreau, Viviane Guerin, Martine Renard, M R Boisseau, Bernard Begaud, Mathieu Molimard, Nicholas MooreAbstract:Abstract Introduction: The “French paradox”, a low cardiovascular mortality compared to the prevalent risk factors, has been attributed to the regular use of red wine, and to the polyphenols it contains. These have among other effects an antioxidant and antithrombotic effect. The French paradox is maximal in southwest France, a region which is the region of production of armagnac, an oak cask aged spirit also rich in polyphenols. Method: We tested the effects of a freeze-dried extract of 12-year-old armagnac (EA88) on in vitro human platelet adhesion, and on aggregation induced by collagen or ADP, in the presence or absence of hypoxanthine–xanthine oxidase (HX/XO), at concentrations ranging from 5×10−9 to 5×10−3 g/l, after 15–60 min incubation. We also tested the effects of 2-week oral treatment with 1, 5 and 25 mg/kg EA88 in a rat arteriovenous Shunt Thrombosis model. Results: EA88 inhibited ADP-induced but not collagen-induced human platelet aggregation in vitro in a concentration- and incubation time-dependent manner, which was greater in the presence of HX/XO. In vivo, giving rats a daily oral dose of EA88 for 2 weeks inhibited thrombus formation in a dose-dependent manner, for doses consistent with the habitual human use of armagnac. Conclusion: Armagnac extract EA88 had an antiplatelet and antithrombotic effect that if confirmed in man could contribute to explain the intensity of the French paradox in southwest France.
Sitaram M Emani - One of the best experts on this subject based on the ideXlab platform.
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abstract 11099 use of glycoprotein iib iiia inhibition in prevention of blalock taussig Shunt Thrombosis in pediatric cardiac surgery
Circulation, 2019Co-Authors: Breanna L Piekarski, David Zurakowski, Jenna Rogers, Sitaram M EmaniAbstract:Introduction: Morbidity and mortality related to Thrombosis of modified Blalock-Taussig Shunts (mBTS) remain a significant risk. Platelet inhibition following mBTS is known to reduce the risk of th...
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intravenous gpiib iiia inhibitor for secondary prevention of Shunt Thrombosis in a pediatric patient
The Annals of Thoracic Surgery, 2015Co-Authors: Sirisha Emani, Aditya K Kaza, Melvin C Almodovar, Ravi R Thiagarajan, Sitaram M EmaniAbstract:Thrombosis occurs after aortopulmonary Shunting in children despite the use of heparin and oral antiplatelet agents. We describe the use of an intravenous antiplatelet agent for secondary prevention of Shunt Thrombosis without adverse events. Platelet mapping was used to monitor the effects and demonstrated the rapid onset of platelet inhibition.
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hypercoagulability markers predict Thrombosis in single ventricle neonates undergoing cardiac surgery
The Annals of Thoracic Surgery, 2013Co-Authors: Sirisha Emani, Cameron C Trenor, Frank A. Pigula, Christopher W. Baird, David Zurakowski, Sitaram M EmaniAbstract:Background Incidence of Thrombosis in neonates undergoing cardiac surgery is as high as 20%, and single ventricle physiology (SVP) may present an even higher risk. We hypothesize that SVP is a risk factor for Thrombosis in neonates undergoing cardiac surgery, and hypercoagulability biomarkers are predictive of postoperative Thrombosis. Methods Records of 512 neonates undergoing cardiac surgery were retrospectively reviewed. Thrombosis was defined by clinical events (Shunt Thrombosis, limb ischemia, and stroke) or intravascular or cardiac thrombus by echocardiography. Clinical variables, including SVP and cardiopulmonary bypass (CPB), were analyzed using multivariable logistic regression. A hypercoagulability biomarker panel was obtained in a subset of patients with SVP and compared between neonates with and without Thrombosis. Results Thrombosis was detected in 51 of 512 neonates undergoing cardiac surgery. Intensive care and hospital lengths of stay were longer in patients who experienced Thrombosis compared with those who did not (14 ± 13 vs 6 ± 1 days, 23 ± 4 vs 13 ± 1 days, p p = 0.038). Thrombin generation, plasminogen activator inhibitor, and thrombin activatable fibrinolysis inhibitor were significantly elevated in SVP patients with Thrombosis compared to without Thrombosis (p . Conclusions Single ventricle physiology patients are at higher risk for Thrombosis compared with other neonates after cardiac surgery. Hypercoagulable panel testing may help risk stratify patients and guide patient specific anticoagulation management in the postoperative period.
Sirisha Emani - One of the best experts on this subject based on the ideXlab platform.
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intravenous gpiib iiia inhibitor for secondary prevention of Shunt Thrombosis in a pediatric patient
The Annals of Thoracic Surgery, 2015Co-Authors: Sirisha Emani, Aditya K Kaza, Melvin C Almodovar, Ravi R Thiagarajan, Sitaram M EmaniAbstract:Thrombosis occurs after aortopulmonary Shunting in children despite the use of heparin and oral antiplatelet agents. We describe the use of an intravenous antiplatelet agent for secondary prevention of Shunt Thrombosis without adverse events. Platelet mapping was used to monitor the effects and demonstrated the rapid onset of platelet inhibition.
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hypercoagulability panel testing predicts Thrombosis in neonates undergoing cardiac surgery
American Journal of Hematology, 2014Co-Authors: Frank A. Pigula, Cameron C Trenor, Christopher W. Baird, David Zurakowski, Sirisha EmaniAbstract:Thrombosis contributes to morbidity and mortality in neonates following cardiac surgery. Alterations in hemostatic factors following cardiac surgery have been described, but there is no data correlating these changes with risk of Thrombosis in neonates. The aim of this study is to predict Thrombosis in neonates undergoing cardiac surgery by assessment of a panel of hypercoagulability markers. Neonates undergoing cardiac surgery were enrolled preoperatively and prospectively followed. Preoperative hypercoagulability panel testing included thrombin generation assay (TGA), immunoassays for antithrombin III, protein C, protein S, factor VIII, thrombin-activatable fibrinolytic inhibitor (TAFI), plasminogen activator inhibitor-1 (PAI-1), and cardiolipin antibody. Postoperative Thrombosis was defined by clinical events (Shunt Thrombosis, limb ischemia, and stroke) or imaging (intravascular or intracardiac thrombus). Risk factors for Thrombosis were assessed. One hundred neonates were enrolled in the study over a two-year period. The incidence of postoperative in-hospital Thrombosis was 20%. The only significant clinical risk factor associated with Thrombosis was the single ventricle physiology. Hypercoagulability factors associated with increased risk of Thrombosis by univariate analysis were elevated PAI-1, TAFI, and TGA, and presence of anticardiolipin antibodies. Multivariable logistic regression analysis demonstrated that elevated PAI-1 (P 5 0.015), TAFI (P 5 0.028), and TGA (P 5 0.007) were independent predictors of Thrombosis. Hypercoagulability panel testing may help identify neonates at high risk for Thrombosis following cardiac surgery. Future studies are warranted to determine if high risk patients benefit from targeted anticoagulation therapies. Am. J. Hematol. 89:151–155, 2014. V C 2013 Wiley Periodicals, Inc.
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hypercoagulability markers predict Thrombosis in single ventricle neonates undergoing cardiac surgery
The Annals of Thoracic Surgery, 2013Co-Authors: Sirisha Emani, Cameron C Trenor, Frank A. Pigula, Christopher W. Baird, David Zurakowski, Sitaram M EmaniAbstract:Background Incidence of Thrombosis in neonates undergoing cardiac surgery is as high as 20%, and single ventricle physiology (SVP) may present an even higher risk. We hypothesize that SVP is a risk factor for Thrombosis in neonates undergoing cardiac surgery, and hypercoagulability biomarkers are predictive of postoperative Thrombosis. Methods Records of 512 neonates undergoing cardiac surgery were retrospectively reviewed. Thrombosis was defined by clinical events (Shunt Thrombosis, limb ischemia, and stroke) or intravascular or cardiac thrombus by echocardiography. Clinical variables, including SVP and cardiopulmonary bypass (CPB), were analyzed using multivariable logistic regression. A hypercoagulability biomarker panel was obtained in a subset of patients with SVP and compared between neonates with and without Thrombosis. Results Thrombosis was detected in 51 of 512 neonates undergoing cardiac surgery. Intensive care and hospital lengths of stay were longer in patients who experienced Thrombosis compared with those who did not (14 ± 13 vs 6 ± 1 days, 23 ± 4 vs 13 ± 1 days, p p = 0.038). Thrombin generation, plasminogen activator inhibitor, and thrombin activatable fibrinolysis inhibitor were significantly elevated in SVP patients with Thrombosis compared to without Thrombosis (p . Conclusions Single ventricle physiology patients are at higher risk for Thrombosis compared with other neonates after cardiac surgery. Hypercoagulable panel testing may help risk stratify patients and guide patient specific anticoagulation management in the postoperative period.
Anwar Umar - One of the best experts on this subject based on the ideXlab platform.
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effect of traditional uyghur medicine abnormal savda munziq extract on rabbit platelet aggregation in vitro and rat arteriovenous Shunt Thrombosis in vivo
Journal of Ethnopharmacology, 2015Co-Authors: Anwar Umar, Nicholas Moore, Wuliya Yimin, Ibadet Tohti, Halmurat Upur, Benedicte BerkeAbstract:Abstract Objective Abnormal Savda Munziq (ASMq) is a standard herbal preparation used in Uyghur traditional medicine to fight chronic diseases including cardiovascular, but its specific effects on Thrombosis and platelet aggregation are unknown. Methods Rabbit platelets were incubated with ASMq extract (10, 20, 40 µg/ml) for 15, 30, or 60 min, and aggregation was induced with ADP and collagen. In vivo, ASMq extract 2.97 g/kg, 5.94 g/kg, 11.88 g/kg per os daily for 15 days were tested on thrombus wet weight in a rat model of arterio-venous bypass Thrombosis. Plasma thromboxane B2 (TXB 2 ) and 6-keto-PGF1a (6PG) were measured by radioimmunoassay. Aspirin (12 µg/ml and 5 mg/kg) and saline were used as control in both experiments. Results ASMq inhibited ADP and collagen-induced aggregation in vitro in a dose-dependent manner that increased over time, to a maximum of 6.4±1.3% and 21.6±4.0% for ADP and collagen, respectively, at one hour׳s incubation with the highest concentration, whereas the effects of aspirin (34.5±2.2% and 41.9±2.5%, respectively) were stable over time. In vivo, ASMq inhibited thrombus formation dose-dependently, by 70% at the highest dose, compared to 67% with aspirin. ASMq essentially did not change prostaglandin production, compared to the clear inhibition by aspirin. Conclusion Abnormal Savda Munziq extract inhibits dose-dependent platelet aggregation with ADP or collagen in vitro and Thrombosis in vivo to values similar to those of aspirin, though unlike aspirin this effect does not seem mediated by an inhibition of cyclo-oxygenase.
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effect of armagnac fractions on human platelet aggregation in vitro and on rat arteriovenous Shunt Thrombosis in vivo probably not related only to polyphenols
Thrombosis Research, 2007Co-Authors: Najim Al A Awwadi, Anne Borrotbouttefroy, Anwar Umar, Cedric Saucier, Marieclaude Segur, Charles Garreau, Mireille Canal, Yves Glories, Nicholas MooreAbstract:Abstract Previous studies showed that alcohol-free extracts of Armagnac, an oak cask aged spirit rich in polyphenols, inhibit human platelet function in vitro and in vivo, in an experimental rat arteriovenous Shunt Thrombosis model and in human healthy volunteers. To identify active compounds, we fractionated a freeze-dried extract of a 10-year-old Armagnac using successively chloroform, diethyl ether and ethyl acetate. The 4 resulting fractions were tested on in vitro human platelet aggregation induced by ADP and in vivo on arteriovenous Shunt Thrombosis after 10 days oral treatment in rats. Active components were found mainly in fractions 1 and 3: at the highest concentration (2.4 10 − 2 g/l), in vitro ADP-induced aggregation was inhibited by 62.7 ± 2.1% and 51.2 ± 3.8% for F1 and F3, respectively, vs 18.9 ± 2.4% and 13.9 ± 0.4% for fractions 2 and 4 and 33.6 ± 1.5% for the crude extract. There was a significant decrease in thrombus weight with the crude extract and all fractions tested after 10 days treatment with 2.5 mg/kg/day orally, greatest with fraction 1. Characterisation of phenol content showed that fraction 1, the most biologically active, was essentially devoid of ellagic acid and ellagitannins, the polyphenols initially thought responsible for the effect, whereas fraction 2 which was mostly inactive, was the richest in polyphenols. Conclusion The antiplatelet and antithrombotic activity of Armagnac seems mostly unrelated to polyphenols.
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aqueous extracts of ocimum basilicum l sweet basil decrease platelet aggregation induced by adp and thrombin in vitro and rats arterio venous Shunt Thrombosis in vivo
Thrombosis Research, 2006Co-Authors: Ibadet Tohti, Anwar Umar, Maynur Tursun, Subat Turdi, Horyat Imin, Nicholas MooreAbstract:Objective To study the effects of aqueous extract of Ocimum basilicum L (OBL) on platelet aggregation and experimental thrombus. Methods Platelet aggregation induced by ADP (5 μM) and thrombin (4 UI), and thrombus weight in an arteriovenous Thrombosis (AVT) model were tested after 2 weeks treatment with 15, 75 and 375 mg/kg OBL orally in rats, compared to 8.8 mg/kg/day aspirin. AVT was also tested 2 h after 75 mg/kg OBL orally, after 3 and 7 days treatment, and one, three and seven days after the end of a two-week treatment. Analysis was done by ANOVA followed by protected t-tests (Tukey). Results OBL (15, 75, 375 mg/Kg) dose-dependently inhibits platelet aggregation by ADP and thrombin, with 75 mg/kg/day having approximately the same effect as 8.8 mg/kg/day aspirin. ADP induced aggregation reached 45%, 28% and 18% for OBL, respectively, 15, 75, 375 mg/kg compared to 71% for control and 27% for aspirin (all p < 0.01 except aspirin vs. OBL 75 mg/kg/day p = 0.7). Thrombin-induced aggregation reached 33%, 22%, 21% for OBL, respectively, 15, 75, 375 mg/kg compared to 67% for control and 48% for aspirin (all p < 0.01 except OBL 75 vs. OBL 375 mg/kg/day, p = 1.0). Compared to a control thrombus weight of 48.1 mg (SD 4.9), thrombus weight was 29.4 (3.3), 19.0 (1.9) and 12.3 (1.7) after treatment for 2 weeks with 15, 75 and 375 mg/kg OBL, respectively, and 27.4 (5.3) after 8.8 mg/kg aspirin (all p < 0.001 except aspirin vs. OBL 75 mg/kg/day p = 1.0). Maximum effect of OBL was reached after one week's treatment. The effect subsided between 3 and 7 days. Conclusion OBL possesses an inhibitory effect on platelet aggregation induced by ADP and thrombin, that is dose-dependent and results in an anti-thrombotic effect in vivo which develops progressively over 7 days and disappears over 3–7 days. The active ingredient now needs to be characterized.
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effects of armagnac extracts on human platelet function in vitro and on rat arteriovenous Shunt Thrombosis in vivo
Thrombosis Research, 2003Co-Authors: Anwar Umar, Charles Garreau, Viviane Guerin, Martine Renard, M R Boisseau, Bernard Begaud, Mathieu Molimard, Nicholas MooreAbstract:Abstract Introduction: The “French paradox”, a low cardiovascular mortality compared to the prevalent risk factors, has been attributed to the regular use of red wine, and to the polyphenols it contains. These have among other effects an antioxidant and antithrombotic effect. The French paradox is maximal in southwest France, a region which is the region of production of armagnac, an oak cask aged spirit also rich in polyphenols. Method: We tested the effects of a freeze-dried extract of 12-year-old armagnac (EA88) on in vitro human platelet adhesion, and on aggregation induced by collagen or ADP, in the presence or absence of hypoxanthine–xanthine oxidase (HX/XO), at concentrations ranging from 5×10−9 to 5×10−3 g/l, after 15–60 min incubation. We also tested the effects of 2-week oral treatment with 1, 5 and 25 mg/kg EA88 in a rat arteriovenous Shunt Thrombosis model. Results: EA88 inhibited ADP-induced but not collagen-induced human platelet aggregation in vitro in a concentration- and incubation time-dependent manner, which was greater in the presence of HX/XO. In vivo, giving rats a daily oral dose of EA88 for 2 weeks inhibited thrombus formation in a dose-dependent manner, for doses consistent with the habitual human use of armagnac. Conclusion: Armagnac extract EA88 had an antiplatelet and antithrombotic effect that if confirmed in man could contribute to explain the intensity of the French paradox in southwest France.
David Zurakowski - One of the best experts on this subject based on the ideXlab platform.
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abstract 11099 use of glycoprotein iib iiia inhibition in prevention of blalock taussig Shunt Thrombosis in pediatric cardiac surgery
Circulation, 2019Co-Authors: Breanna L Piekarski, David Zurakowski, Jenna Rogers, Sitaram M EmaniAbstract:Introduction: Morbidity and mortality related to Thrombosis of modified Blalock-Taussig Shunts (mBTS) remain a significant risk. Platelet inhibition following mBTS is known to reduce the risk of th...
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hypercoagulability panel testing predicts Thrombosis in neonates undergoing cardiac surgery
American Journal of Hematology, 2014Co-Authors: Frank A. Pigula, Cameron C Trenor, Christopher W. Baird, David Zurakowski, Sirisha EmaniAbstract:Thrombosis contributes to morbidity and mortality in neonates following cardiac surgery. Alterations in hemostatic factors following cardiac surgery have been described, but there is no data correlating these changes with risk of Thrombosis in neonates. The aim of this study is to predict Thrombosis in neonates undergoing cardiac surgery by assessment of a panel of hypercoagulability markers. Neonates undergoing cardiac surgery were enrolled preoperatively and prospectively followed. Preoperative hypercoagulability panel testing included thrombin generation assay (TGA), immunoassays for antithrombin III, protein C, protein S, factor VIII, thrombin-activatable fibrinolytic inhibitor (TAFI), plasminogen activator inhibitor-1 (PAI-1), and cardiolipin antibody. Postoperative Thrombosis was defined by clinical events (Shunt Thrombosis, limb ischemia, and stroke) or imaging (intravascular or intracardiac thrombus). Risk factors for Thrombosis were assessed. One hundred neonates were enrolled in the study over a two-year period. The incidence of postoperative in-hospital Thrombosis was 20%. The only significant clinical risk factor associated with Thrombosis was the single ventricle physiology. Hypercoagulability factors associated with increased risk of Thrombosis by univariate analysis were elevated PAI-1, TAFI, and TGA, and presence of anticardiolipin antibodies. Multivariable logistic regression analysis demonstrated that elevated PAI-1 (P 5 0.015), TAFI (P 5 0.028), and TGA (P 5 0.007) were independent predictors of Thrombosis. Hypercoagulability panel testing may help identify neonates at high risk for Thrombosis following cardiac surgery. Future studies are warranted to determine if high risk patients benefit from targeted anticoagulation therapies. Am. J. Hematol. 89:151–155, 2014. V C 2013 Wiley Periodicals, Inc.
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hypercoagulability markers predict Thrombosis in single ventricle neonates undergoing cardiac surgery
The Annals of Thoracic Surgery, 2013Co-Authors: Sirisha Emani, Cameron C Trenor, Frank A. Pigula, Christopher W. Baird, David Zurakowski, Sitaram M EmaniAbstract:Background Incidence of Thrombosis in neonates undergoing cardiac surgery is as high as 20%, and single ventricle physiology (SVP) may present an even higher risk. We hypothesize that SVP is a risk factor for Thrombosis in neonates undergoing cardiac surgery, and hypercoagulability biomarkers are predictive of postoperative Thrombosis. Methods Records of 512 neonates undergoing cardiac surgery were retrospectively reviewed. Thrombosis was defined by clinical events (Shunt Thrombosis, limb ischemia, and stroke) or intravascular or cardiac thrombus by echocardiography. Clinical variables, including SVP and cardiopulmonary bypass (CPB), were analyzed using multivariable logistic regression. A hypercoagulability biomarker panel was obtained in a subset of patients with SVP and compared between neonates with and without Thrombosis. Results Thrombosis was detected in 51 of 512 neonates undergoing cardiac surgery. Intensive care and hospital lengths of stay were longer in patients who experienced Thrombosis compared with those who did not (14 ± 13 vs 6 ± 1 days, 23 ± 4 vs 13 ± 1 days, p p = 0.038). Thrombin generation, plasminogen activator inhibitor, and thrombin activatable fibrinolysis inhibitor were significantly elevated in SVP patients with Thrombosis compared to without Thrombosis (p . Conclusions Single ventricle physiology patients are at higher risk for Thrombosis compared with other neonates after cardiac surgery. Hypercoagulable panel testing may help risk stratify patients and guide patient specific anticoagulation management in the postoperative period.