Abstract

Objectives: We evaluated the effectiveness of monitoring coagulation parameters and plasma heparin levels in patients receiving heparin treatment for acute myocardial infarction (AMI).

Patients and Methods: The study included 30 AMI patients (19 males, 11 females; range 39 to 76 years) who were admitted to the intensive care unit. All patients received standard heparin with a bolus dosage (5,000 IU) followed by continuous intravenous infusion (1,000 IU/h) for 72 hours. Thrombolytic therapy was not applied because of contraindications. Coagulation parameters (aPTT, TT, and AT III) were monitored on coagulometer ACL 2000 at baseline and 24 hours after the initiation of heparin therapy together with plasma heparin levels. Statistical analyses were made using one-sample Kolmogorov-Smirnov test, and paired-samples t-test.

Results: Fifteen patients had below-therapeutic heparin levels during treatment, which were associated with significantly increased aPTT and decreased AT III values (p<0.001). The remaining patients with therapeutic heparin levels exhibited the same trend with regard to aPTT and AT III. However, increase in TT values was significant only in the latter group (p<0.001).

Conclusion: The two methods, plasma heparin monitoring and standard coagulograms seem to be equally effective for control over heparin therapy, and their combined use enhances the efficacy and safety of heparin treatment.