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Enhanced ultrasound imaging searches for, destroys and helps manage blood clots
Obese patients may be at higher risk of bleeding when taking warfarin
Embargoed for 11:30 a.m. PT/2:30 p.m. ET– Abstract 36
Enhanced ultrasound imaging searches for, destroys and helps manage blood clot treatment
An enhanced type of ultrasound imaging offers a potential way to simultaneously diagnose and treat blood clots, as well as monitor patients’ responses to clot-dissolving drugs.
Researchers combined the clot-dissolving drug urokinase with an activated-platelet-specific single-chain antibody, which is an antibody that targets blood clots. They put the search-and-destroy duo on the surface of microbubbles, which are used to enhance ultrasound imaging.
In essence, they created a new way to use ultrasound to find, target and dissolve blood clots using tiny air bubbles.
The researchers monitored clot size in mice with ultrasound imaging and measured bleeding time after experimental injury, while comparing four treatment groups: 1) microbubbles coated with both the antibody and urokinase; 2) targeted microbubbles and a high dose of urokinase administered separately; 3) targeted microbubbles and a low dose of urokinase administered separately; and 4) a control group with targeted-microbubbles coated and no urokinase.
Treatment with the microbubbles that had the targeting single-chain antibody and urokinase on the surface notably reduced clot size within an hour without causing bleeding problems.
Similar clot-dissolving efficacy with urokinase application alone (the current clinical practice) could only be achieved with a high dose of urokinase that caused bleeding problems.
While research is in the early stages, this innovative technology could lead to major progress in the rapid diagnosis and treatment of cardiovascular disease. The new technology can help patients that are suffering from the devastating consequences of blood clots such as heart attacks and some types of strokes. In addition the technology can help patients with clots that build up in deep veins of the legs possibly causing pulmonary embolism.
The newly developed technology promises to have a major impact on fast and effective treatment of patients in the emergency department, researchers said.
Peter Karlheinz, M.D., Ph.D.; Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
Embargoed for 1 p.m. PT/4 p.m. ET – Abstract 388
Obese patients may be at higher risk of bleeding when taking Warfarin
Obese patients taking the frequently-used blood thinner warfarin have a higher risk of bleeding than normal weight patients taking the drug.
Researchers conducted a one-year study of 863 patients taking warfarin. Using body mass index (BMI), a way to evaluate body weight status, the researchers evaluated patients for abnormal bleeding, including major gastrointestinal (digestive system) and brain bleeds, and minor bleeds, such as those on the skin.
More than 8 percent, or 71 patients, had abnormal bleeding during the study. Among the reported bleeds, about a third (35.2 percent) were major and two-thirds (64.8 percent) were minor.
Among the patients studied, 21 percent were of normal weight, 38 percent were overweight, and 41.3 percent of patients were classified as obese.
Obese patients on warfarin were almost twice as likely as normal weight patients to experience a major bleed.
While patients should not discontinue warfarin use because of their weight, future studies are needed to understand why obesity increases bleeding risk for warfarin patients and whether similar risks exist for other types of blood thinners, researchers said.
Adedotun A. Ogunsua, M.D.; University of Massachusetts Medical School, Worcester, Mass.
Note: Actual presentation is 5:30 p.m. PT/2:30 p.m. ET, 11:30 a.m. PT Friday, May 8, 2015.
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