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Treatment by activated protein C of patients with disseminated intravascular coagulation Double-blind trial with heparin



Treatment by activated protein C of patients with disseminated intravascular coagulation Double-blind trial with heparin



Blood 96(11 Part 1): 50a, November 16



(Objective) We examined the therapeutic efficacy of plasma-derived activated protein C concentrates (APC) on the clinical manifestations and mortality of patients with disseminated intravascular coagulation (DIC). (Design) We conducted a double-blind trial with heparin in 104 patients with DIC. These patients were randomly assigned to receive either APC (n=49, 300 U/kg/day) or heparin (n=55, 192 IU/kg/day) for 6 days. One unit of APC was defined as the amount to double the activated partial thromboplastin time of standard human plasma (1 ml) and 0.2 mg/ml (approx.) of APC corresponds to 1 U/ml. (Results) Bleeding was reduced by 45.8% in APC group, while it was reduced by 27.3% in heparin group (p<0.02). Although bleeding was worsened in 8 out of 55 patients in heparin group, no such worsening was found in APC group. Both decrease in the plasma level of cross-linked fibrin degradation products and increase in the plasma level of antithrombin were significantly more marked in APC group than those in heparin group (p<0.04 in each comparison). The mortality evaluated one month after the end of these therapies was 20.4% and 40.0% in APC group and heparin group, respectively, and the difference was found to be statistically significant (p<0.05). No side effect was observed in patients given APC. (Conclusions) These findings strongly suggest that APC can be more useful than heparin in treating patients with DIC and the therapeutic efficacy of APC might be dependent on its safety property by which the coagulation abnormalities can be corrected without any adverse effects.

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Accession: 035980083

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