The effect of a combined application of acetylsalicylic acid and heparin on haemostasis is examined on 7 healthy test persons. Apart from the change of the plasmatic coagulation and the platelet function by the pharmaca a prolongation of the bleeding time which is larger than the values of the individual application can be established. In the in-vitro-experiment could be proved that the prolonged bleeding time is based on the prevented by acetylsalicylic acid release of the heparin neutralising factor 4 from the platelets. An improvement of the therapeutic effect of heparin when at the same time acetylsalicylic acid is given is discussed.
In continuation of previous in vitro experiments the influence of glucose infusions on the following haemostatic functions was investigated: bleeding time, platelet count, platelet aggregation, release reaction, fibrinogen concentration, partial thromboplastin time. Five volunteers with normal metabolism a glucose infusion (100 g) was given for two hrs. Before, 1, 2, 3, 4 and 5 hrs after the beginning of the infusion blood sugar, insulin level and haemostatic parameters were determined. Apart from an increase in the glucose and insulin level, a prolonged bleeding time, increased platelet count, inhibition of platelet aggregation and release reaction occurred. Simultaneously, fibrinogen concentration increased and partial thromboplastin time shortened. The possible causes of these changes in haemostasis during glucose supply are discussed.
It is reported on the results of a training treatment for outpatients after myocardial infarction which was carried out twice a week during one and a half year, compared to a control group without physical conditioning. Out of 30 patients 14 continuously took part in the training lessons. In contrast to the control group in the training group a clear increase of the working capacity, a slight decrease of the body-weight, of the blood pressure in rest and of the triglycerides in the serum as well as a favourable influence on the glucose tolerance could be proved. The serum cholesterol level and the coagulation parameters did not change significantly. One patient of the training group and one of the control group died. One patient of the training group and one patient of the control group suffered a reinfarction.
The influence of the triiodinated angiographic contrast medium Visotrast 370 on haemostasis was studied in a total of 30 angiographic examinations with and without previous injection of 5,000 IU heparin. The contrast medium alone caused prolongation of bleeding time and inhibition of plasmatic coagulation. The effect of the contrast medium was enhanced by injection of heparin. The fibrinogen concentration remained unchanged in all cases. Aggregation of platelets enhanced by the contrast medium was found to be further increased by heparin. Enhanced platelet aggregation is considered an essential factor in the incidence of thromboembolic complications during engiographic examinations. Since heparin does not inhibit platalet function, the use of inhibitors of aggregation is discussed.
The influence of blood platelets on the recalcification time under hirudin was investigated. Contrary to the investigations of whole-blood which reveal a pathological prolongation of the hirudin tolerance test only at platelet numbers under 30,000/mug, a change of the recalcification time under hirudin could also be found in the plasma at higher platelet numbers. The recalcification time increased inversely proportionally with falling platelet number. The shortening of time in platelets rich plasma attributed to the activity of platelet factor 3. Differences in the examinations of whole-blood may be attributed to an erythrocyte activity similar to factor 3. The application of hirudin for determining platelet factor 3 is recommended as a sensible method easily to be performed in practice.
On 15 patients in the in-vitro-experiment the effect of carbenicillin on the collagen-induced aggregation of platelets and the release of the platelet factor 4 neutralising heparin is examined. In a high dosage carbenicillin leads to an inhibition of these platelet functions. Therefore, a combination of carbenicillin with heparin may cause an increased readiness for haemorrhage for the patient.
