Different patterns of heparin resistance: Therapeutic implications

Marco Ranucci, Giuseppe Isgrò, Anna Cazzaniga, Antonio Ditta, Alessandra Boncilli, Mauro Cotza, Giovanni Carboni, Simonetta Brozzi

Research output: Contribution to journalArticlepeer-review

Abstract

Heparin resistance (HR) during cardiac operations is a common feature. Its aetiology often recognizes a decrease in circulating antithrombin III (AT III) due to a preoperative heparin treatment. Nevertheless, some papers high-lighted the existence of HR in patients with normal values of AT III. This paper was designed in order to identify this subgroup of AT III-independent heparin-resistant patients. Five hundred consecutive patients scheduled for coronary revascularization with cardiopulmonary bypass were enrolled in this prospective trial. HR was identified in 104 (20.8%) patients. Thirty-six of them (7.2% of the total population) had a preoperative AT III activity ≥100%, and were defined as AT III-independent heparin-resistant patients. This subgroup significantly differs from the AT III-dependent heparin-resistant group being affected by a less severe degree of HR and including less patients pretreated with heparin. Unlike the other heparin-resistant patients, these subjects do not respond to AT III supplementation aimed at reaching supranormal AT III activity values.

Original languageEnglish
Pages (from-to)199-204
Number of pages6
JournalPerfusion
Volume17
Issue number3
DOIs
Publication statusPublished - 2002

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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