Experimental and clinical data suggest that low molecular weight (LMW) heparins not only have an antithrombotic activity but also a profibrinolytic effect. To assess the profibrinolytic effect of the LMW heparin calcium nadroparine (CY216), 20 patients undergoing surgery were enrolled in a randomized study in which CY216 (3075 AXa IU [0.3 ml]/day) subcutaneously 2 hours before surgery and daily for 7 post-operative days was compared with placebo. The coagulation and fibrinolytic profiles of the patients were determined before and after venous stasis in baseline conditions and 1, 4, and 8 days after surgery. The following parameters were evaluated: functional activity of antithrombin III, plasminogen, alpha2-antiplasmin, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI), and tPA antigen. During the postoperative period, a significant decrease in plasminogen levels and an increase in alpha2-antiplasmin levels were observed in the patients in the placebo group. In the patients treated with CY216, recovery of the plasminogen levels was evident on postoperative day 4, with a significant, but smaller increase of alpha2-antiplasmin. Venous stasis did not induce any modification of tPA antigen values before surgery; after surgery, a significant increase of tPA antigen was observed only in the CY216 group. The PAI values were similar in both groups before and after surgery. These preliminary data suggest that the LMW heparin CY216 may have a moderate profibrinolytic effect.
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