Potency Adjusted Bovine Heparin is Comparable to Porcine Heparin in Patients Undergoing Open Heart Surgery

Abstract

IntroductionHeparin obtained from bovine intestinal mucosa is being considered for reintroduction in cardiovascular, surgical, and interventional procedures. Although the anticoagulant potency of bovine heparin is weaker (130–140 U/mg) than that of porcine heparin (180–200 U/mg), when potencies are adjusted to equivalent USP U/mL activity, both porcine and bovine heparin exhibit comparable anticoagulant activities in in‐vivo and in‐vitro settings.AimThe primary aim of this study was to compare bovine and porcine heparins at equivalent dosing in terms of anticoagulation and potential bleeding effects in patients undergoing coronary artery bypass graft (CABG) surgery.Materials and MethodsCoagulation parameters and biomarkers of inflammation were measured in 32 patients included in a single center, blinded, controlled clinical trial, randomized to CABG surgery with either bovine or porcine heparin. Equivalent dosages of 28,500 units (potency adjusted to 10,000 U/mL) total dose heparin were used. Blood samples were collected at multiple times during and after surgery to measure global clotting activity (ACT, APTT) and amidolytic anti‐Xa levels. TNFa, IL‐6, and TFPI antigen were measured by ELISA; activated protein Cwas measued by a clot‐based assay. A preliminary report of these results has been published (Int J Cardiol 223:611–612, 2016).ResultsAll coagulation parameters (ACT, APTT, anti‐Xa, residual bleeding) demonstrated comparable heparinization (p ≥ 0.05). The only difference between groups was an increased amount of protamine required to neutralize bovine heparin after surgery determined by ACT; expected due to the higher gravimetric quantity of bovine heparin used to adjust the U/mL potency. No differences were found between groups in levels of acute inflammatory markers (p ≥ 0.05).ConclusionThis study shows that bovine and porcine heparins at potency adjusted dosages are equivalent anticoagulant drugs in CABG surgery resulting in comparable perioperative coagulation, bleeding, and anti‐inflammatory effects.Support or Funding InformationNone.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.