بروز ترومبوسيتوپني ناشي از هپارين ، در دو روش تجويز داخل وريدي در بيماران با سندرم حاد كرونري

Incidence of Thrombocytopenia Induced by Two Methods of Intravenous Heparin injection in Patients with Acute Coronary Syndrome

Background: Intravenous heparin is an effective treatment in patients with acute coronary syndrome, and adrninistrered either by 6 hours bolus intravenus injection or continuous in fusion. Thrombocytopenia induced by heparin injection have been reported 0-30%, that is variable by different methods of heparin administration. This study was carried out to determine the incidence of thrombocytopenia in both methods of intravenous heparin administration in patients referred to CCU of Aliehn Abitaleb Hospital, Rafsanjan. Materials and Methods: This clinical trial was carried out in 64 patient (35male and 29 female) with mean age of 52±6 years who admitted in CCU with acute coronary syndrome . 32 patients received continuous infusion (group A) and 32 patients recicvd intermittent intravenous bolus injection of heparin every six hours (group B). Because of hospitalization duration of shorter than 24 hours, 4 patients (2 males and 2 females) from group B and 1 (male) from group A excluded from the study. Dosage of heparin adjusted based on body weight and Aptt measurement of 1.5-2 times of control levels. CʹBC and platelet count was done on the day of admission, 3 and 7 days after heparin administration. Results: There were not significant differences between two groups for age, sex and total amounts of prescribed heparin. There were 4 (14.8%) cases with thrombocytopenia in-group B, and one cases (3.1%) in group A, this difference was significant statistically (p<0.05). There was no significant difference in platelet count in group A (210000±20000/mm^6663) compare to group B (208000±18000/mm^3). Conclusion: Thrombocytopenia induced by heparin, was significantly lower in continuous infusion of heparin compare to intermittent intravenous bolus injection. Therefore continuous infusion of heparin is recommended for patients with acute coronary syndrome who needs heparin therapy .