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Effect of Nafamostat Mesilate on Bradykinin Generation and Hemodynamics During LDL Apheresis
- Source :
- Artificial Organs. 19:135-139
- Publication Year :
- 1995
- Publisher :
- Wiley, 1995.
-
Abstract
- Dextran-sulfate (DS) cellulose used for low-density lipoprotein (LDL) apheresis seems to be a weak activator of the contact phase of the intrinsic coagulation pathway because the surface of this substance has negative charges. Heparin, a commonly used anticoagulant, has no effect on this process whereas the process is inhibited by a newly developed anticoagulant, nafamostat mesilate (NM). The effects on bradykinin generation were compared between heparin and NM. Five patients with severe hypercholesterolemia were treated with LDL apheresis using either heparin or NM on a different day. During apheresis with heparin, factor XII, high molecular weight kininogen, and prekallikrein were markedly decreased by passing through the DS column. A distinct generation of bradykinin was observed by passing plasma through the DS column, and this led to the rise of bradykinin levels from 12 +/- 5 (mean +/- SE) to 72 +/- 14 pg/ml after treatment of 1,000 ml of plasma. NM suppressed almost completely the rise of bradykinin levels. Although blood pressure was apt to decrease during apheresis with heparin, there was no significant difference in blood pressure between heparin and NM. Since an angiotensin-converting enzyme inhibitor may lead to a marked rise in blood levels of bradykinin by suppressing its degradation, the use of NM is recommended for apheresis in patients taking this drug.
- Subjects :
- Adult
Male
Adolescent
High-molecular-weight kininogen
medicine.drug_class
Hypercholesterolemia
Biomedical Engineering
Medicine (miscellaneous)
Bradykinin
Bioengineering
Pharmacology
Guanidines
Biomaterials
chemistry.chemical_compound
medicine
Humans
Factor XII
Heparin
Anticoagulant
Hemodynamics
Prekallikrein
General Medicine
Middle Aged
Benzamidines
Lipoproteins, LDL
chemistry
LDL apheresis
Immunology
Blood Component Removal
Female
medicine.drug
Lipoprotein
Subjects
Details
- ISSN :
- 15251594 and 0160564X
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Artificial Organs
- Accession number :
- edsair.doi.dedup.....2b108a30a84af6a2e590f360d234e7d8