A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients

Philip E. Greilich, Barbara M. Alving, Kathleen L. O'Neill, Audrey S. Chang, Thomas J. Reid

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

The monoclonal antibody, c7E3 Fab, binds to the platelet surface fibrinogen receptor (GPIIb/IIIa), inhibiting platelet aggregation and clot retraction. We performed an in vitro study to assess the ability of a modification of the thromboelastograph (MTEG) to detect inhibition of clot strength by c7E3 Fab and its reversal with platelet-rich plasma (PRP). In the modified assay (MTEG), thrombin was added to whole blood (WB) and platelet- poor plasma (PPP) and the resultant maximum amplitude (MA) was measured, MA(WB) and MA(PPP), respectively. Anticoagulated blood samples from 17 patients scheduled for cardiac surgery were collected for a dose response (Part I; n = 5) and c7E3 Fab reversal (Part II; n = 12) study. Clot strength was reduced in a dose-dependent manner by c7E3 Fab. Ecteola cellulose effectively reversed the effect of heparin on the thrombin time and the addition of PRP significantly increased the MA(WB) (P < 0.0001) and MA(WB- PPP)) (P < 0.0001). Subtracting the MA(PPP) from MA(WB) significantly magnified the response of MA to the addition of c7E3 Fab (P = 0.002) and its reversal with PRP (P = 0.005). This in vitro study indicates that the MTEG is a responsive assay demonstrating that inhibition by the antiplatelet c7E3 Fab is reversible with PRP.

Original languageEnglish (US)
Pages (from-to)31-38
Number of pages8
JournalAnesthesia and Analgesia
Volume84
Issue number1
DOIs
StatePublished - 1997

Fingerprint

Platelet-Rich Plasma
Blood Platelets
Clot Retraction
Fibrinogen Receptors
Thrombin Time
Platelet Aggregation
Thrombin
Cellulose
Thoracic Surgery
Heparin
abciximab
Monoclonal Antibodies
In Vitro Techniques

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients. / Greilich, Philip E.; Alving, Barbara M.; O'Neill, Kathleen L.; Chang, Audrey S.; Reid, Thomas J.

In: Anesthesia and Analgesia, Vol. 84, No. 1, 1997, p. 31-38.

Research output: Contribution to journalArticle

Greilich, Philip E. ; Alving, Barbara M. ; O'Neill, Kathleen L. ; Chang, Audrey S. ; Reid, Thomas J. / A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients. In: Anesthesia and Analgesia. 1997 ; Vol. 84, No. 1. pp. 31-38.
@article{36cabd86d91148ae9bfbc0cd25bd3a89,
title = "A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients",
abstract = "The monoclonal antibody, c7E3 Fab, binds to the platelet surface fibrinogen receptor (GPIIb/IIIa), inhibiting platelet aggregation and clot retraction. We performed an in vitro study to assess the ability of a modification of the thromboelastograph (MTEG) to detect inhibition of clot strength by c7E3 Fab and its reversal with platelet-rich plasma (PRP). In the modified assay (MTEG), thrombin was added to whole blood (WB) and platelet- poor plasma (PPP) and the resultant maximum amplitude (MA) was measured, MA(WB) and MA(PPP), respectively. Anticoagulated blood samples from 17 patients scheduled for cardiac surgery were collected for a dose response (Part I; n = 5) and c7E3 Fab reversal (Part II; n = 12) study. Clot strength was reduced in a dose-dependent manner by c7E3 Fab. Ecteola cellulose effectively reversed the effect of heparin on the thrombin time and the addition of PRP significantly increased the MA(WB) (P < 0.0001) and MA(WB- PPP)) (P < 0.0001). Subtracting the MA(PPP) from MA(WB) significantly magnified the response of MA to the addition of c7E3 Fab (P = 0.002) and its reversal with PRP (P = 0.005). This in vitro study indicates that the MTEG is a responsive assay demonstrating that inhibition by the antiplatelet c7E3 Fab is reversible with PRP.",
author = "Greilich, {Philip E.} and Alving, {Barbara M.} and O'Neill, {Kathleen L.} and Chang, {Audrey S.} and Reid, {Thomas J.}",
year = "1997",
doi = "10.1097/00000539-199701000-00006",
language = "English (US)",
volume = "84",
pages = "31--38",
journal = "Anesthesia and Analgesia",
issn = "0003-2999",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients

AU - Greilich, Philip E.

AU - Alving, Barbara M.

AU - O'Neill, Kathleen L.

AU - Chang, Audrey S.

AU - Reid, Thomas J.

PY - 1997

Y1 - 1997

N2 - The monoclonal antibody, c7E3 Fab, binds to the platelet surface fibrinogen receptor (GPIIb/IIIa), inhibiting platelet aggregation and clot retraction. We performed an in vitro study to assess the ability of a modification of the thromboelastograph (MTEG) to detect inhibition of clot strength by c7E3 Fab and its reversal with platelet-rich plasma (PRP). In the modified assay (MTEG), thrombin was added to whole blood (WB) and platelet- poor plasma (PPP) and the resultant maximum amplitude (MA) was measured, MA(WB) and MA(PPP), respectively. Anticoagulated blood samples from 17 patients scheduled for cardiac surgery were collected for a dose response (Part I; n = 5) and c7E3 Fab reversal (Part II; n = 12) study. Clot strength was reduced in a dose-dependent manner by c7E3 Fab. Ecteola cellulose effectively reversed the effect of heparin on the thrombin time and the addition of PRP significantly increased the MA(WB) (P < 0.0001) and MA(WB- PPP)) (P < 0.0001). Subtracting the MA(PPP) from MA(WB) significantly magnified the response of MA to the addition of c7E3 Fab (P = 0.002) and its reversal with PRP (P = 0.005). This in vitro study indicates that the MTEG is a responsive assay demonstrating that inhibition by the antiplatelet c7E3 Fab is reversible with PRP.

AB - The monoclonal antibody, c7E3 Fab, binds to the platelet surface fibrinogen receptor (GPIIb/IIIa), inhibiting platelet aggregation and clot retraction. We performed an in vitro study to assess the ability of a modification of the thromboelastograph (MTEG) to detect inhibition of clot strength by c7E3 Fab and its reversal with platelet-rich plasma (PRP). In the modified assay (MTEG), thrombin was added to whole blood (WB) and platelet- poor plasma (PPP) and the resultant maximum amplitude (MA) was measured, MA(WB) and MA(PPP), respectively. Anticoagulated blood samples from 17 patients scheduled for cardiac surgery were collected for a dose response (Part I; n = 5) and c7E3 Fab reversal (Part II; n = 12) study. Clot strength was reduced in a dose-dependent manner by c7E3 Fab. Ecteola cellulose effectively reversed the effect of heparin on the thrombin time and the addition of PRP significantly increased the MA(WB) (P < 0.0001) and MA(WB- PPP)) (P < 0.0001). Subtracting the MA(PPP) from MA(WB) significantly magnified the response of MA to the addition of c7E3 Fab (P = 0.002) and its reversal with PRP (P = 0.005). This in vitro study indicates that the MTEG is a responsive assay demonstrating that inhibition by the antiplatelet c7E3 Fab is reversible with PRP.

UR - http://www.scopus.com/inward/record.url?scp=0031016637&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031016637&partnerID=8YFLogxK

U2 - 10.1097/00000539-199701000-00006

DO - 10.1097/00000539-199701000-00006

M3 - Article

VL - 84

SP - 31

EP - 38

JO - Anesthesia and Analgesia

JF - Anesthesia and Analgesia

SN - 0003-2999

IS - 1

ER -