Key result
Nafamostat mesylate maintains acceptable coagulation during LVAD support in dogs, avoiding bleeding caused by argatroban.
Why the study?
Optimal anticoagulation strategies during left ventricular assist device use remain unclear, necessitating evaluation of different anticoagulants in a controlled setting.
Do different anticoagulation strategies (argatroban, nafamostat mesylate, or nafamostat mesylate + prostacyclin analog) improve coagulation parameters in dogs undergoing 24-hour left ventricular assist compared to no anticoagulation?
Do different anticoagulation strategies (argatroban, nafamostat mesylate, or nafamostat mesylate + prostacyclin analog) improve coagulation parameters in dogs undergoing 24-hour left ventricular assist compared to no anticoagulation?
In a canine model of LVAD support, combined nafamostat mesylate and a prostacyclin analog optimized coagulation parameters without significantly prolonging prothrombin time, whereas argatroban produced a bleeding tendency.
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Nafamostat mesylate may optimize coagulation parameters versus argatroban in LVAD models; leaves open human translation pending trials.
Takahama et al. (2000) studied Left ventricular assist device (LVAD) support (n=36). Argatroban, nafamostat mesylate, or nafamostat mesylate + prostacyclin analog vs. No anticoagulation was evaluated on Blood coagulation parameters (prothrombin time, fibrinogen, alpha2-plasmin inhibitor). In 36 dogs undergoing 24-hour LVAD support, argatroban prevented intrinsic coagulation pathway activation but caused bleeding, while nafamostat mesylate maintained acceptable coagulation parameters.
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