New assays have been developed to detect the presence of economically motivated additives (EMAs) and poor manufacturing processes in heparin. Here, selected oversulfated glycosaminoglycans that are possible EMAs to heparin were synthesized and the utility of current (1)H NMR, SAX-HPLC or anticoagulation time protocols were evaluated for the detection of native impurities (chondroitin sulfate A or B (CSA or CSB), or heparan sulfate (HS)), or synthetic contaminants (oversulfated-(OS)-CSA, OS-CSB, OS-HS or OS-Heparin) spiked into heparin sodium active pharmaceutical ingredients (APIs). The range of w/w percent LOD values from the SAX-HPLC analysis for heparin spiked with CSA, CSB, HS, OS-CSA, OS-CSB, OS-HS, OS-Heparin and two partially oversulfated CSA analogs was 0.05-0.12%. The 500 MHz 1D-(1)H NMR spectra of heparin spiked with 1.0-10% CSA, CSB, OS-CSA, or OS-CSB showed unique signal pattern changes while the samples spiked with HS, OS-HS, OS-Heparin or partially sulfated CSA were more difficult to identify using NMR data. The ratio of anticoagulation time values obtained with factor Xa and factor IIa were found to remain within USP specifications in the presence of 10% amounts of these impurities or contaminants. In a separate test, using OS-CSA spiked API heparin samples, the factor Xa or factor IIa to USP standard ratio were found to fall below the USP 0.9 specification value in samples spiked at ca. weight percent of 15% or greater of OSCS. We conclude that the SAX-HPLC assay is the most sensitive and robust assay to identify and quantitate possible GAG-based EMAs in heparin.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jpba.2010.02.019 | DOI Listing |
Trials
December 2024
Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Background: Intermediate-high risk pulmonary embolism (PE) carries a significant risk of hemodynamic deterioration or death. Treatment should balance efficacy in reducing clot burden with the risk of complications, particularly bleeding. Previous studies on high-dose, short-term thrombolysis with alteplase (rtPA) showed a reduced risk of hemodynamic deterioration but no change in mortality and increased bleeding complications.
View Article and Find Full Text PDFAtrial fibrillation (AF) and heart failure (HF) often accompany each other, as they share similar risk factors and pathophysiological mechanisms. AF in patients with HF is known to increase hospitalizations and worsen prognosis. A combination of AF and HF translates into high risks of thromboembolic complications, which renders anticoagulants an important aspect of therapy for these patients.
View Article and Find Full Text PDFBMC Cardiovasc Disord
December 2024
Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Background: Delayed lead perforation is a rare complication of cardiac implantable electronic device (CIED). Clinical presentations range from completely asymptomatic to pericardial tamponade. Surgical lead extraction is recommended and transvenous lead extraction (TLE) with surgical backup is an alternative method.
View Article and Find Full Text PDFBlood Coagul Fibrinolysis
October 2024
Hematology Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Nowadays, direct oral anticoagulants (DOACs) represent the gold standard for venous thromboembolism (VTE) treatment and VTE secondary prophylaxis; nevertheless, the percentage of elderly patients in major trials and literature data about DOACs usage for VTE secondary prophylaxis in the elderly are scant. Our retrospective study tried to evaluate low-dose DOACs efficacy and safety for elderly VTE secondary prophylaxis in a real-life setting. A cohort of 73 patients (≥ 75 years) considered at high risk of VTE recurrence was treated with apixaban 2.
View Article and Find Full Text PDFPharmacy (Basel)
December 2024
R&D for Clinical Activity in Telemedicine, Italian National Health Agency-AGENAS, 00187 Rome, Italy.
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics to control their cardiac rhythm, with periodic follow-up checks. Despite the great ease of handling these drugs, we soon realized the need for follow-up models that would allow the appropriateness and safety of these pharmacological treatments to be monitored over time.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!