Benefit of adding low molecular weight heparin to the conventional treatment of stable angina pectoris. A double-blind, randomized, placebo-controlled trial.

Abstract

BACKGROUND:

Patients with chronic coronary artery disease exhibit a dysfunctioning endothelium, which may be responsible for exercise-induced platelet activation and expression of a procoagulant moiety. In this study, we evaluated the therapeutic efficacy of a low molecular weight heparin (Parnaparin) in patients with stable angina pectoris.

METHODS AND RESULTS:

According to a double-blind, randomized, placebo-controlled trial, 29 patients with stable exercise-induced angina pectoris and angiographically proven coronary artery disease received a single daily subcutaneous injection of Parnaparin or placebo on top of aspirin and conventional antianginal medication over 3 months. Patients randomized to Parnaparin showed a significant decrease in the fibrinogen level (P = .035) and an improvement in both the time to 1-mm ST segment depression (P = .008) and the peak ST segment depression (P = .015). The Canadian Cardiovascular Society class for angina pectoris was also improved by Parnaparin (P = .016). Parnaparin did not affect ADP and collagen-induced platelet aggregation, whereas thrombin-induced aggregation was reduced (P = .0001). The bleeding time was slightly prolonged, but this was not associated with any significant bleeding.

CONCLUSIONS:

Patients with stable angina pectoris may be treated with Parnaparin in addition to aspirin and conventional antianginal medication. Side effects are negligible, and compliance is excellent.

• Authors: G Melandri, F Semprini, V Cervi, N Candiotti, E Palazzini, A Branzi, B Magnani
• Journal: Circulation (Circulation) Vol. 88 Issue 6 Pg. 2517-23 (Dec 1993) ISSN: 0009-7322 [Print] United States
• PMID: 8252662 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Cardiovascular Agents
• Heparin, Low-Molecular-Weight
• Fibrinogen
• parnaparin

Topics

• Adult
• Aged
• Angina Pectoris (blood, drug therapy, physiopathology)
• Bleeding Time
• Cardiovascular Agents (administration & dosage)
• Double-Blind Method
• Drug Therapy, Combination
• Exercise Test
• Female
• Fibrinogen (metabolism)
• Heparin, Low-Molecular-Weight (administration & dosage)
• Humans
• In Vitro Techniques
• Male
• Middle Aged
• Platelet Aggregation (drug effects)