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Do Opioid Addicts Require Higher Doses of Heparin During Percutaneous Coronary Intervention?

Tahereh Afaghnia1, Mohammad Nasim-Tajik2, Elham Boushehri3

  • 1Student Research Committee, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Addiction & Health
|February 18, 2022
PubMed

Insights

Opioid addicts showed lower activated clotting time (ACT) during percutaneous coronary intervention (PCI) despite receiving standard heparin doses. This suggests opioid users may need increased heparin for effective anticoagulation during PCI.

Area of Science:

  • Cardiology
  • Pharmacology
  • Addiction Medicine

Background:

  • Percutaneous coronary intervention (PCI) necessitates anticoagulation, typically with heparin, to prevent thrombotic events.
  • Opioid addiction may alter heparin's efficacy, potentially requiring dose adjustments during PCI procedures.

Purpose of the Study:

  • To compare the effect of a standard heparin dose on activated clotting time (ACT) in opioid addicts versus non-addicts undergoing PCI.
  • To investigate potential differences in anticoagulation response between these patient groups.

Main Methods:

  • A comparative study involving 107 patients (50 opioid addicts, 57 non-addicts) scheduled for elective PCI.
  • Standard heparin administration (100 IU/kg) at procedure start, with ACT measurements at 2 and 30 minutes.
  • Baseline characteristics and coagulation parameters (PT, PTT, INR, platelet count) were recorded.

Main Results:

  • Opioid addicts exhibited significantly lower ACT levels at both 2 and 30 minutes post-heparin administration compared to non-addicts.
  • While hyperlipidemia was more prevalent in non-addicts and smoking in opioid addicts, baseline coagulation tests and heparin dosage were similar.
  • ACT at 2 minutes correlated with aspirin use in opioid addicts and inversely with smoking in non-addicts.

Conclusions:

  • Opioid addicts demonstrate a diminished response to standard heparin dosing during PCI, indicated by lower ACT.
  • These findings suggest that opioid-addicted patients may require higher heparin doses to achieve adequate anticoagulation and prevent thrombotic complications during PCI.
Abstract

Keywords:
Activated clotting timeHeparinOpioidsPercutaneous coronary intervention

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