Prevention of left ventricular mural thrombus.
Acute myocardial infarction is associated with a high incidence of left ventricular mural thrombosis, which causes most of the systemic emboli. A double-blind trial was undertaken in patients with anterior transmural myocardial infarction to evaluate the ability of a high-dose heparin regimen to prevent left ventricular mural thrombosis. The high dose consisted of 12,500 U of calcium heparin subcutaneously every 12 hours for 10 days, which was compared with a low dose consisting of 5,000 U every 12 hours. The formation of left ventricular mural thrombosis was assessed by means of 2-dimensional echocardiography on day 10 after infarction. The high-dose group had a significantly lower incidence of left ventricular mural thrombosis than did the low-dose group. This was achieved without increasing the incidence of bleeding. The benefits of high-dose heparin were associated with maintaining plasma heparin concentrations at 0.2 U/ml and activated partial thromboplastin time between 50 and 60 seconds.
Turpie
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AG
HGH-McMaster Clinic, Hamilton General Hospital, Ontario, Canada.
D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004452:Echocardiography; D006331:Heart Diseases / Q000209:etiology / Q000517:prevention & control*; D006493:Heparin / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*; D010314:Partial Thromboplastin Time; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
D006493:Heparin