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Heparin-induced transaminase elevations: a prospective study
A Guevara1, J Labarca, G González-Martin
1Faculty of Chemistry, Department of Pharmacy, Pontifical Catholic University, Santiago, Chile.
International Journal of Clinical Pharmacology, Therapy, and Toxicology
|March 1, 1993
Summary
Heparin therapy can cause adverse drug reactions, including abnormal serum transaminase elevation. Younger male patients are more susceptible to alanine transaminase increases, which are dose-dependent.
Area of Science:
- Pharmacology
- Clinical Medicine
- Hepatology
Background:
- Heparin is a widely used anticoagulant.
- Adverse drug reactions (ADRs) associated with heparin therapy require careful monitoring.
- Elevated serum transaminases are a potential indicator of drug-induced liver injury.
Purpose of the Study:
- To investigate the incidence and characteristics of adverse reactions to heparin therapy.
- To specifically examine the occurrence of abnormal serum transaminase elevation (ALAT and ASAT) during heparin treatment.
- To identify patient factors and dosage relationships associated with heparin-induced transaminase changes.
Main Methods:
- Prospective surveillance study of 54 hospitalized patients receiving heparin.
- Defined abnormal transaminase elevation as a >20% rise from baseline.
- Utilized UV spectrophotometry for serum transaminase level determination.
- Employed global introspection for causality assessment of ADRs.
Main Results:
- Overall ADR incidence was 24.1%; 14.8% were heparin-related.
- Heparin-induced alanine transaminase (ALAT) elevation occurred in 5.5% of patients, and aspartate transaminase (ASAT) in 9.3%.
- Younger male patients showed a higher frequency of heparin-induced ALAT elevation.
- Heparin-induced ALAT elevation was statistically associated with higher doses (154,220 IU vs. 96,210 IU).
Conclusions:
- Heparin therapy is associated with a notable incidence of adverse reactions, particularly elevated serum transaminases.
- Patient demographics (age, sex) and heparin dosage are significant factors in the development of heparin-induced ALAT elevation.
- These transaminase elevations were generally mild, did not prolong hospital stays, and did not require specific treatment.