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Potency Adjusted Bovine Heparin is Comparable to Porcine Heparin in Patients Undergoing Open Heart Surgery
Author(s) -
Gomes Walter,
Braile Domingo,
Leal Joao Carlos,
Guizilini Solange,
Regenga Marisa,
Kouta Ahmed,
Walenga Jeanine,
Jeske Walter,
Hoppensteadt Debra,
Ramacciotti Eduardo,
Nader Helena,
Lima Marcelo,
Fareed Jawed
Publication year - 2019
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2019.33.1_supplement.819.8
Subject(s) - heparin , medicine , potency , activated clotting time , anticoagulant , protamine , coagulation , pharmacology , anesthesia , surgery , in vitro , chemistry , biochemistry
Introduction Heparin obtained from bovine intestinal mucosa is being considered for reintroduction in cardiovascular, surgical, and interventional procedures. Although the anticoagulant potency of bovine heparin is weaker (130–140 U/mg) than that of porcine heparin (180–200 U/mg), when potencies are adjusted to equivalent USP U/mL activity, both porcine and bovine heparin exhibit comparable anticoagulant activities in in‐vivo and in‐vitro settings. Aim The primary aim of this study was to compare bovine and porcine heparins at equivalent dosing in terms of anticoagulation and potential bleeding effects in patients undergoing coronary artery bypass graft (CABG) surgery. Materials and Methods Coagulation parameters and biomarkers of inflammation were measured in 32 patients included in a single center, blinded, controlled clinical trial, randomized to CABG surgery with either bovine or porcine heparin. Equivalent dosages of 28,500 units (potency adjusted to 10,000 U/mL) total dose heparin were used. Blood samples were collected at multiple times during and after surgery to measure global clotting activity (ACT, APTT) and amidolytic anti‐Xa levels. TNFa, IL‐6, and TFPI antigen were measured by ELISA; activated protein Cwas measued by a clot‐based assay. A preliminary report of these results has been published ( Int J Cardiol 223:611–612, 2016). Results All coagulation parameters (ACT, APTT, anti‐Xa, residual bleeding) demonstrated comparable heparinization ( p ≥ 0.05). The only difference between groups was an increased amount of protamine required to neutralize bovine heparin after surgery determined by ACT; expected due to the higher gravimetric quantity of bovine heparin used to adjust the U/mL potency. No differences were found between groups in levels of acute inflammatory markers ( p ≥ 0.05). Conclusion This study shows that bovine and porcine heparins at potency adjusted dosages are equivalent anticoagulant drugs in CABG surgery resulting in comparable perioperative coagulation, bleeding, and anti‐inflammatory effects. Support or Funding Information None. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .