Plasma free fatty acids and the incidence of arrhythmias in acute myocardial infarction during treatment with small doses of subcutaneous heparin or warfarin.
In a prospective trial, 99 patients with a history of AMI of less than 12 hours were allocated at random to treatment with subcutaneous heparin, 5 000 IU twice daily, (51 patients) or warfarin (48 patients). In a subsample of 21 patients, 11 in the warfarin group and 10 in the heparin group, fasting FFA analyses were performed before and 2 hours after administration of anticoagulants on days 1 and 2. No measurable increase in FFA concentrations was demonstrated in the heparin-treated patients, in spite of a significant influence on the thrombin clotting time. The frequency of ventricular arrhythmias as detected by continuous tape recordings was equal in the two groups. It is concluded that subcutaneous heparin, 5 000 IU every 12 hours, can be administered to patients with AMI without increasing the risk of arrhythmias as compared with warfarin.
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
D005230:Fatty Acids, Nonesterified; D014859:Warfarin; D006493:Heparin