Getting to know Heparin as a treatment for heart disease

Heparin is used in the treatment and prevention of blood clots, prevents blood clots during dialysis, and prevents complications after a heart attack.

There are 2 types of heparin: high molecular weight heparin and low molecular weight heparin.

High molecular weight heparin requires monitoring of blood every day. Low molecular weight heparin provides a better anticoagulant response and does not require daily blood monitoring.

Heparin is used to treat or prevent blood clots where there is a high risk of clotting and thromboembolism, such as atrial fibrillation, myocardial infarction, deep vein thrombosis, knee and thigh surgery, and others.

The role of heparin in the treatment of heart disease
Heparin prevents the formation and development of blood clots by preventing clotting factors that cement together platelets.

Heparin is an anticoagulant that is injected and activates antithrombin III, which blocks thrombin and factor Xa, factors needed in the final stages of blood clotting. Blood clots in the arteries leading to the heart can cause acute coronary syndrome: unstable angina (feeling of tightness in the chest) or heart attack (non-ST segment myocardial infarction - NSTEMI). Medications that prevent the formation of clots (aspirin) or thin the blood (heparin) can alleviate the problem.

Unfractionated Heparin (UFH) and Low Molecular Weight Heparin (LMWH) are 2 types of heparin. Experiments prove the administration of UFH and LMWH in addition to aspirin therapy in patients with unstable angina or NSTEMI in the acute phase of treatment, can prevent heart attacks more than placebo but does not reduce mortality, the need for revascularization procedures, or recurrence of angina. Although information about side effects is limited, heparin can cause minor bleeding.

So far there has been no recent research. Currently 8 studies, including this review. There was no evidence of differences in mortality between the group given heparin and placebo (RR = 0.84, 95% CI 0.36 to 1.98). Compared with placebo, heparin reduced the occurrence of myocardial infarction in patients with unstable angina and NSTEMI (RR = 0.40, 95% CI 0.25 to 0.63, NNTB = 33). There was a trend of major bleeding in the heparin study compared with the control study (RR = 2.05, 95% CI 0.01 to 4.24). The assessment of the risk of bias in this study is limited because research generally does not provide sufficient detail to assess the potential risk of bias.

Compared with placebo, patients given heparin had the same risk of mortality, revascularization, recurrence of angina, and thrombocytopenia. However, patients treated with heparin had a reduced risk of myocardial infarction and a higher incidence of minor bleeding. Overall, the evidence assessed in this review is classified as low quality according to the GRADE approach. The results of this review must be interpreted with caution.

Heparin decreases the number of heart attacks but causes minor bleeding after non-ST elevation in acute coronary syndromes compared to placebo.

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