Why the study?
Does antithrombin gamma supplementation improve activated clotting time and allow successful completion of PCI in patients with acquired antithrombin deficiency-related heparin resistance?
Does antithrombin gamma supplementation improve activated clotting time and allow successful completion of PCI in patients with acquired antithrombin deficiency-related heparin resistance?
Antithrombin gamma supplementation may be an effective treatment option for acquired antithrombin deficiency-related heparin resistance and subsequent intraprocedural thrombotic events during PCI.
Acquired AT deficiency may underlie heparin resistance during PCI in septic DIC; hypothesis-generating for targeted monitoring or supplementation.
A 75-year-old man receiving treatment for necrotizing pancreatitis developed septic disseminated intravascular coagulation and acute coronary syndrome (ACS). During percutaneous coronary intervention (PCI), a large amount of fresh thrombi appeared after balloon dilatation for the ACS-culprit lesion. Given the low plasma antithrombin (AT) activity and poorly prolonged activated clotting time (ACT), we suspected that acquired AT deficiency-related heparin resistance (HR) was responsible for the thrombus formation. Administration of AT gamma markedly improved ACT, and we successfully completed PCI. We suggest that AT gamma be considered a treatment option for AT deficiency-related HR and subsequent intraprocedural thrombotic events.
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Yokoi et al. (2022) studied this question.
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