Low-Dose Heparin Pretreatment is not Able to Prevent Clotting Activation during Coronary Angiography

Abstract

The common use of coronary angiography in the treatment of coronary artery disease has 1. Methods prompted many investigations on changes in hemostasis activation during this procedure. Many 1.1. Patients factors may interfere with the results obtained: previous pharmacological treatments, catheterization The study population consisted of 25 consecutive, procedures, drugs administered during procedures, unselected patients with coronary artery disease (21 radiographic contrast media (CM), etc. [1]. An immen and 4 women), aged 41–73 years, referred to portant issue is the role played in hemostatic changes the Institute of Internal Medicine and Cardiology for by non ionic CM, which have been shown to be pocoronary angiography. All patients were on therapy tentially thrombogenic [2–4]. A limited number of with standard antianginal drugs. No patient had prein vivo studies have indicated that both platelet and existing hemostatic defects or anticoagulant treatclotting activation occur after coronary angiography ment. Aspirin (100–325 mg/day) had been taken performed by non ionic CM [3,5,6]. Recently, Mukfor at least one month before angiography by all herjee et al. [6] observed a marked blood clotting patients. The study was carried out according to activation during coronary angiography (not prethe principles of Helsinki declaration. ceded by heparin treatment), whereas such an activation was not found after PTCA in which a heparin bolus of 20000 IU was injected. No information is 1.2. Coronary Angiography available about the occurrence of blood clotting activation during coronary angiography performed by Coronary angiography was performed through the non ionic CM when a low dose of heparin is adminisfemoral approach with a 6 F catheter. All patients during the procedure received 3000 IU of heparin intravenously (i.v). About 150–200 ml of CM were Abbrevations: CM, constrast media; SPA, spontaneous platelet aggregation; TAT, thrombin-antithrombin complexes; PRP, plateinjected into coronary arteries during each examilet-rich-plasma. nation; the CM employed was a low-osmolar non Corresponding author: Rosanna Abbate, Clinica Medica Generale ionic one, iohexol sodium (Omnipaque-Nycomed, e Cardiologia, Universita di Firenze, Viale Morgagni 85, 50134 Firenze, Italia. Tel: 139 (55) 4277954; Fax: 139 (55) 4277608. Norway).