Randomised controlled trial of subcutaneous calcium-heparin in acute myocardial infarction. The SCATI (Studio sulla Calciparina nell'Angina e nella Trombosi Ventricolare nell'Infarto) Group.
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| Abstract |
In a multicentre study 711 patients were randomised to a group receiving calcium-heparin, 12,500 U, subcutaneously (360), or to a group receiving no heparin (351), beginning within 24 h of the onset of symptoms. 433 of these patients, admitted within 6 h, were given intravenous streptokinase (SK). Results were analysed for the in-hospital period. Calcium-heparin had no significant effects on the frequency of electrocardiographically documented ischaemic episodes or non-fatal reinfarction in the whole series; in the subgroup receiving SK, transient ischaemic episodes recurred in 14.2% of those treated with heparin vs 19.6% of the controls (p = 0.08). Mortality was significantly lower in the calcium-heparin treated patients, both in the overall groups (21/360 vs 35/351, p = 0.03) and in the SK subgroups (10/218 vs 19/215, p = 0.05). In 200 patients with first anterior myocardial infarction, it was possible to assess the effect of heparin on left ventricular mural thrombosis. On predischarge two-dimensional echocardiography, the prevalence of thrombus was significantly lower in the heparin group than in the control group (19/107 vs 34/93). Heparin also greatly reduced the incidence of thrombus formation in those who were thrombus-free on admission. Complications of heparin treatment were few.
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| Journal | Lancet (London, England) (Lancet) Vol. 2 Issue 8656 Pg. 182-6 (Jul 22 1989) ISSN: 0140-6736 [Print] England |
| PMID | 2568520 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't) |
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