Objective: To investigate the impact of bivalirudin alternative treatment on antiheparin/platelet factor 4 antibody levels perioperatively in rats undergoing cardiopulmonary bypass (CPB).
Methods: Two groups of rats received heparin pretreatment and two groups of rats not, and during CPB all the four groups received either bivalirudin or heparin. Pre-CPB and post-CPB day 7 venous blood samples were used to determine the levels of antiheparin/PF4 antibody immunoglobulin (Ig) G with enzyme-linked immunosorbent assay.
Results: Preoperative heparin pretreatment increased the antiheparin/PF4 antibody IgG levels (P < .01), while the administration of heparin further increased this levels (P < .01). The use of bivalirudin prevented further increase in antiheparin/PF4 antibody IgG levels.
Conclusion: Bivalirudin, as a direct thrombin inhibitor, could circumvent the increased antiheparin/PF4 antibody level in circulation due to the heparin administration.
Keywords: antiheparin/platelet factor 4 antibody; bivalirudin; cardiopulmonary bypass; unfractionated heparin.