Pericardial fluid and serum VEGF in response to different types of heparin treatment.
BACKGROUND
Heparin is an important medication in the treatment of patients with unstable angina pectoris. We designed an observational study to compare the effects of standard heparin (SH) with low molecular weight heparin (LMWH) on vascular endothelial growth factor (VEGF) levels in patients undergoing coronary artery bypass grafting (CABG).


METHODS
Thirty-two patients with unstable angina pectoris undergoing CABG were prospectively categorized into two groups according to the type of heparin administration before surgery. VEGF levels determined by enzyme linked immunosorbent assay (ELISA) were compared between the two groups' blood samples obtained before the surgery and pericardial fluid after pericardial opening.


RESULTS
There was no difference in preoperative characteristics between the two groups. Serum VEGF levels were similar (P=0.3) in patients treated by SH (85+/-55 pg/ml) compared to those treated with LMWH (105+/-64 pg/ml). VEGF levels in the pericardial fluid were significantly raised (P<0.0001) in patients of LMWH group (36+/-13 pg/ml) compared to SH group (13+/-6 pg/ml). A good correlation was observed between VEGF in the serum and platelet count in both SH group (r=0.8) and LMWH group (r=0.7).


CONCLUSIONS
Local response of the ischemic myocardium, as expressed by VEGF levels, differs in patients treated with SH compared to patients treated with LMWH. VEGF levels in pericardial fluid of patients receiving LMWH were 2-3-folds higher than patients in SH group.
Gerrah
Rabin
R
Department of Cardiothoracic Surgery, Hadassah University Hospital, Hebrew University School of Medicine, P.O.B. 12000, 91120 Jerusalem, Israel. rgerrah@yahoo.com
Tshori
Sagi
S
Gilon
Dan
D
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000378:metabolism* / Q000601:surgery; D000925:Anticoagulants / Q000494:pharmacology*; D001026:Coronary Artery Bypass; D005260:Female; D006493:Heparin / Q000494:pharmacology*; D006495:Heparin, Low-Molecular-Weight / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000737:chemistry; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis* / Q000097:blood / Q000187:drug effects*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D042461:Vascular Endothelial Growth Factor A; D006493:Heparin