Related Experiment Videos
Decrease in frequency of anginal episodes by control of thrombin generation with low-dose heparin: a controlled
G G Neri Serneri1, R Abbate, D Prisco
1Clinica Medica I, University of Florence, Italy.
Insights
Low-dose heparin effectively controls thrombin generation, significantly reducing anginal activity in patients with spontaneous angina. This treatment improves symptoms and increases symptomless periods, indicating a favorable impact on anginal disease management.
Area of Science:
- Cardiology
- Hematology
Background:
- Increased thrombin generation correlates with heightened anginal activity.
- Spontaneous angina requires effective management strategies to control thrombin generation.
Purpose of the Study:
- To investigate if controlling thrombin generation with low-dose heparin impacts anginal activity.
- To evaluate the efficacy of heparin in managing spontaneous angina.
Main Methods:
- A 12-month, randomized, single-blind, cross-over study involving 24 angina patients.
- Patients received either low-dose heparin (12,500 IU subcutaneously) or placebo for 6-month periods.
- Thrombin generation (fibrinopeptide A levels) and anginal activity were assessed bi-weekly.
Main Results:
- Low-dose heparin significantly reduced fibrinopeptide A plasma levels (p < 0.001).
- Heparin treatment led to a 53% decrease in severely symptomatic angina and a 30% decrease in mildly symptomatic angina.
- The symptomless angina class increased by 23% during heparin treatment (p < 0.001).
Conclusions:
- Controlling thrombin generation with low-dose heparin favorably impacts anginal activity in spontaneous angina patients.
- Heparin therapy offers a viable strategy for managing angina by targeting thrombin generation.
Abstract:
Increased thrombin generation is frequently associated with an increase in anginal activity. A cross-over, single-blind, completely randomized study was planned in order to evaluate whether the control of thrombin generation affected the increase in anginal activity. After discharge from the hospital, 24 patients (18 men and 6 women, aged 40 to 69 years) suffering from spontaneous angina were followed up to 12 months and were alternatively treated during two consecutive 6-month periods with calcium heparin, 12,500 IU by the subcutaneous route, or with placebo by the intramuscular route, in addition to the usual antianginal medications. Thrombin generation and clinical activity of angina were assessed every 15 days by measuring fibrinopeptide A (FPA) plasma levels and by grading in three classes (symptomless, mildly symptomatic, and severely symptomatic) the anginal activity on the basis of the number and the time concentration of the ischemic attacks and ECG changes. Low-dose heparin treatment significantly reduced both the FPA plasma level (from 4.1 +/- 3.7 to 2.3 +/- 1.8 ng/ml, p less than 0.001) and the clinical activity of angina. During heparin treatment, the frequency of the observations in the severely and mildly symptomatic classes decreased, respectively, by 53% and by 30%, whereas that in the symptomless class increased by 23% (p less than 0.001) in comparison with the period on placebo. Present results indicate that the control of thrombin generation obtained by low-dose heparin treatment favorably affects the degree of anginal activity in patients with spontaneous angina.