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Effects of heparin treatment on collateral development and regional myocardial function in acute myocardial
1Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Insights
Heparin treatment during acute myocardial infarction improved coronary collateral development and preserved left ventricular function. This suggests heparin is beneficial for heart attack recovery by enhancing blood flow post-infarction.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Pharmacology
Background:
- Acute myocardial infarction (AMI) poses significant risks to cardiac function.
- Coronary collateral circulation plays a crucial role in mitigating infarct size and preserving myocardial function.
- The impact of early therapeutic interventions on collateral development requires further elucidation.
Purpose of the Study:
- To investigate the effect of heparin administration during the acute phase of anterior myocardial infarction on coronary collateral development.
- To assess the influence of heparin on regional myocardial function in patients recovering from their first anterior myocardial infarction.
Main Methods:
- Angiographic evaluation of collateral visualization (collateral index) in the infarct-related artery.
- Assessment of regional wall motion and left ventricular ejection fraction in 18 patients post-myocardial infarction.
- Comparison between a group receiving heparin (170-220 IU/kg/day) and a control group without heparin during the acute infarction phase.
Main Results:
- Patients treated with heparin exhibited a significantly higher collateral index compared to the control group (1.5 vs. 0.4, p < 0.05).
- Left ventricular ejection fraction tended to be higher in the heparin group (49% vs. 38%).
- Significant improvement in regional wall motion of the infarct area was observed in the heparin-treated group (7.4% vs. -0.8% segment shortening, p < 0.05).
Conclusions:
- Heparin treatment during the acute stage of anterior myocardial infarction promotes coronary collateral development.
- This enhanced collateralization with heparin contributes to the preservation of left ventricular function and improved regional myocardial contractility.
- Early heparin administration appears to be a valuable therapeutic strategy for improving outcomes in patients with acute myocardial infarction.
Abstract:
To define the effects of heparin treatment during the acute stage of the first anterior myocardial infarction on coronary collateral development and regional myocardial function, we evaluated angiographically the extent of a collateral visualization (collateral index: 0-3) to the completely obstructed infarct-related coronary artery and regional wall motion in 18 patients during convalescence after infarction. The patients were divided into two groups depending on the presence (group I) or absence (group II) of heparin treatment (170 to 220 IU/kg per day) during the acute phase of infarction. The collateral index was significantly higher in group I (1.5 +/- 0.9) than in group II (0.4 +/- 0.4; p less than 0.05). The left ventricular ejection fraction tended to be greater in group I than in group II (49 +/- 12% vs 38 +/- 16%), and there was a significant difference in regional wall motion of the infarct area that was evaluated by the percentage of segment shortening between the two groups (group I:7.4 +/- 9.2%, group II:-0.8 +/- 4.5%, p less than 0.05). These findings indicate that heparin treatment for patients with acute myocardial infarction is worthwhile in terms of the preservation of left ventricular function as a result collateral development.