From the Research
Heparin treatment can increase protein C levels in the bloodstream, as evidenced by a study published in 2002 1, which demonstrated that heparin significantly increased protein C levels in patients with disseminated intravascular coagulation. When heparin is administered, it enhances the activity of antithrombin, which inhibits thrombin formation. This reduction in thrombin leads to decreased activation of protein C, potentially causing a transient decrease in activated protein C levels initially. However, with continued heparin therapy, total protein C levels typically rise as heparin reduces the consumption of protein C in the coagulation cascade. This effect is particularly notable in patients with protein C deficiency or those with conditions involving excessive clotting. The relationship between heparin and protein C is clinically significant because both substances work as anticoagulants, though through different mechanisms. Heparin primarily acts by potentiating antithrombin, while protein C inactivates factors Va and VIIIa. Some key points to consider include:
- In patients with severe protein C deficiency, heparin therapy may be necessary before initiating warfarin to prevent warfarin-induced skin necrosis, as warfarin initially decreases protein C levels before affecting other vitamin K-dependent factors 2.
- Monitoring protein C levels during heparin therapy is not routinely performed but may be considered in specific clinical scenarios where protein C deficiency is suspected 3.
- The use of heparin in patients with protein C deficiency has been shown to be effective in reducing the risk of thrombosis, as demonstrated by a study published in 1988 2.
- Heparin has been compared to other anticoagulants, such as activated protein C, in the treatment of disseminated intravascular coagulation, with heparin showing significant benefits in improving coagulation and fibrinolysis parameters 1.