title: Benefit of adding low molecular weight heparin to the conventional treatment of stable angina pectoris. A double-blind, randomized, placebo-controlled trial.
abstract: BACKGROUND
  Patients with chronic coronary artery disease exhibit a dysfunctioning endothelium, which may be responsible for exercise-induced platelet activation and expression of a procoagulant moiety. In this study, we evaluated the therapeutic efficacy of a low molecular weight heparin (Parnaparin) in patients with stable angina pectoris.
  
  
  RESULTS
  According to a double-blind, randomized, placebo-controlled trial, 29 patients with stable exercise-induced angina pectoris and angiographically proven coronary artery disease received a single daily subcutaneous injection of Parnaparin or placebo on top of aspirin and conventional antianginal medication over 3 months. Patients randomized to Parnaparin showed a significant decrease in the fibrinogen level (P = .035) and an improvement in both the time to 1-mm ST segment depression (P = .008) and the peak ST segment depression (P = .015). The Canadian Cardiovascular Society class for angina pectoris was also improved by Parnaparin (P = .016). Parnaparin did not affect ADP and collagen-induced platelet aggregation, whereas thrombin-induced aggregation was reduced (P = .0001). The bleeding time was slightly prolonged, but this was not associated with any significant bleeding.
  
  
  CONCLUSIONS
  Patients with stable angina pectoris may be treated with Parnaparin in addition to aspirin and conventional antianginal medication. Side effects are negligible, and compliance is excellent.
authors.affiliation: Institute of Cardiology, University of Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Melandri
authors.forename: F
authors.initials: F
authors.lastname: Semprini
authors.forename: V
authors.initials: V
authors.lastname: Cervi
authors.forename: N
authors.initials: N
authors.lastname: Candiotti
authors.forename: E
authors.initials: E
authors.lastname: Palazzini
authors.forename: A
authors.initials: A
authors.lastname: Branzi
authors.forename: B
authors.initials: B
authors.lastname: Magnani
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D001760:Bleeding Time; D002317:Cardiovascular Agents / Q000008:administration & dosage; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005080:Exercise Test; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects
chemical_list: D002317:Cardiovascular Agents; D006495:Heparin, Low-Molecular-Weight; D005340:Fibrinogen; C080945:parnaparin