Comparison of subcutaneous calcium heparin and acetylsalicylic acid in the prevention of ischemic events and death after myocardial infarction: a randomized trial in a consecutive series of 90 patients.
This study compares the prophylactic effectiveness of calcium heparin (CH) with that of acetylsalicylic acid (ASA) in the long-term anticoagulant management of patients with myocardial infarct. Forty-four patients discharged from a coronary care unit after acute myocardial infarction were randomly assigned to receive 12,500 IU subcutaneous CH daily for 3 months, followed by 325 mg ASA daily for 3 months. This protocol was compared with the administration of 325 mg/day ASA to an additional 46 patients for 6 months. There were 16 dropouts in the CH group and two in the ASA group. Ischemic events, surgery, and adverse effects totaled 36 in the CH group versus 73 in the ASA group. Three patients from each group died (6.8% vs. 6.5% in the CH and ASA groups, respectively). Patients in the CH group were significantly older (76 +/- 3.51 years vs. 63 +/- 5.51 years in the CH and ASA groups, respectively; P = 0.026). Although ASA is generally regarded as the most effective way of preventing the recurrence of ischemic events, the results of this study suggest that CH is a potentially useful and well-tolerated alternative that could be employed when ASA is contraindicated.
Ferro
M
M
Division of Cardiology, E. Agnelli Hospital, Pinerolo, 10143 Turin, Italy.
Crivello
R
R
Rizzotti
M
M
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D015331:Cohort Studies; D017023:Coronary Angiography; D003325:Coronary Care Units; D005080:Exercise Test; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000401:mortality* / Q000517:prevention & control*; D055502:Secondary Prevention; D013997:Time Factors; D016312:Treatment Refusal
D005343:Fibrinolytic Agents; C006871:calcium heparin; D006493:Heparin; D001241:Aspirin