Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Pathophysiol Haemost Thromb 2005;34:263–268 DOI: 10.1159/000093105 Combinations of Low Doses of Unfractionated Heparin and of Low-Molecular-Weight Heparin Prevent Experimental Venous Thrombosis Guareide Carelli Francisco H.A. Maffei Luci Mattar Iracema C. Ferrari Izolete A. Thomazini-Santos Lídia R. de Carvalho Faculdade de Medicina and Instituto de Biociências de Botucatu, UNESP, Botucatu, Brazil tion. Thrombus developed in 90.9% of control animals, 20% of the H 350 group, 22.2% of the E 2 group, 10% of the H 175 + E 1 group, and 30% of the H 100 + E 0.5 group; there was a difference between group C and the other groups. Only in the H 350 and H 175 + E 1 groups were TT and acti- vated partial thromboplastin time prolonged in relation to control at the end of the experiment. Forty minutes after injection, TT was prolonged in the H 350 and H 175 + E 1 groups. In conclusion, combinations of low doses of low- molecular-weight heparin and low doses of UH were as effective as high doses of each one used alone in prevent- ing thrombus development in rat vena cava. Copyright © 2005 S. Karger AG, Basel Introduction The standard drug for prevention and treatment of thromboembolism is unfractionated heparin (UH); it has a heterogeneous structure, molecular weight, anticoagu- lant activity and chromatographic affinity. Moreover, it presents pharmacokinetic limitations such as binding to plasmatic proteins, endothelial cells, and leucocytes, re- sulting in a complex clearance mechanism, variability of anticoagulant response, and resistance to heparin [1, 2] . Low-molecular-weight heparins (LMWHs) produce an antithrombotic response with a better dose/effect re- Key Words Low-molecular-weight heparin Experimental thrombosis Rat vena cava Abstract Synergism between low-molecular-weight heparin and low doses of unfractionated heparin (UH) enhancing anti-factor Xa activity and the release of tissue factor pathway inhibitor was observed. The aim of this study was to verify whether this association is effective in pre- venting experimental venous thrombosis. Seventy rats were allocated into 7 groups: the control group treated with distilled water, the H 350 group treated with UH 350 IU/kg, the E 2 group treated with enoxaparin 2 mg/kg, the H 175 group treated with UH 175 IU/kg, the E 1 group treated with enoxaparin 1 mg/kg, the H 175 + E 1 group treated with UH 175 IU/kg plus enoxaparin 1 mg/kg, and the H 100 + E 0.5 group treated with UH 100 IU/kg plus enoxaparin 0.5 mg/kg. Forty minutes after subcutaneous injection, thrombosis was induced in vena cava. Three hours later, if present, thrombi were withdrawn and weighed. Bleeding time, activated partial thromboplastin time, thrombin time (TT), and anti-factor Xa were mea- sured at the beginning and end of the experiment. Forty- eight other animals were treated, but without inducing thrombus, and tests were performed 40 min after injec- Received: April 27, 2005 Accepted after revision: August 29, 2005 Francisco H.A. Maffei Depto. Cirurgia e Ortopedia Faculdade de Medicina de Botucatu, UNESP Botucatu, SP (Brazil) Tel. +55 14 3811 6269, Fax +55 14 3815 7428, E-Mail fmaffei@fmb.unesp.br © 2005 S. Karger AG, Basel 1424–8832/05/0346–0263$22.00/0 Accessible online at: www.karger.com/pht