Hypertransaminasemia with subcutaneous heparin therapy

Area of Science:

• Clinical Medicine
• Pharmacology
• Hepatology

Background:

• Intravenous full-dose heparin is known to potentially elevate serum aminotransferases (GOT and GPT).
• The effects of low-dose subcutaneous heparin on liver enzymes are less understood.

Purpose of the Study:

• To investigate the influence of low-dose subcutaneous heparin on serum aspartate aminotransferase (GOT) and alanine aminotransferase (GPT) levels.
• To assess the incidence and pattern of liver enzyme elevation in patients receiving low-dose heparin for acute myocardial infarction or vascular conditions.

Main Methods:

• A study was conducted on 34 patients with acute myocardial infarction (AMI) and 7 patients with cerebrovascular accidents or calf thrombophlebitis.
• Patients received low-dose subcutaneous heparin (5,000 IU twice daily).
• Serum GOT and GPT levels were monitored throughout the treatment period.

Main Results:

• Twelve male patients with AMI (approximately 35%) showed a secondary elevation of GOT and GPT around the sixth or seventh day of therapy.
• Four patients (two male, two female) with cerebrovascular accidents or thrombophlebitis also exhibited similar increases in GOT and GPT.
• The observed liver enzyme elevations persisted for the duration of heparin treatment.

Conclusions:

• Low-dose subcutaneous heparin administration can lead to elevated serum GOT and GPT levels in patients with AMI and other vascular conditions.
• This suggests a potential hepatotoxic effect of heparin, even at lower therapeutic doses.
• Clinicians should be aware of this potential side effect when prescribing low-dose heparin.