Early reactivation of ischaemia after abrupt discontinuation of heparin in acute myocardial infarction

• Published in: British Heart Journal Vol. 74; no. 2; pp. 131 - 133
• Main Authors: Di Tano, G., Mazzù, A.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.08.1995; BMJ; BMJ Publishing Group LTD
• Subjects: Aspirin - administration & dosage; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Drug Administration Schedule; Fibrinolytic Agents - administration & dosage; Heparin - administration & dosage; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - drug therapy; Myocardial Ischemia - etiology; Pharmacology. Drug treatments; Platelet Aggregation Inhibitors - administration & dosage; Recurrence; Thrombolytic Therapy; Human; Infarct; Withdrawal; Acute; Cardiovascular disease; Anticoagulant; Sudden; Coronary heart disease; Myocardial disease; Vascular disease; Chemotherapy; Treatment; Ischemia; Myocardium; Complication; Heparin; Fibrinolytic
• ISSN: 0007-0769; 1468-201X; 2053-5864
• DOI: 10.1136/hrt.74.2.131

Intravenous heparin after thrombolytic therapy for acute myocardial infarction is an effective, widely used treatment. Six cases of acute myocardial infarction are reported with early disease reactivation following the abrupt discontinuation of heparin infusion three days after alteplase thrombolysis and concomitant aspirin therapy. Immediate reinfusion of heparin resulted in regression of symptomatic ischaemia in all six patients. The activated partial thromboplastin time values, determined four hours before the discontinuation of heparin therapy, were within the therapeutic range in five of the six patients, and no difference was found in the values obtained one hour after the reinfusion of heparin (P = 0.065).