UNSTABLE ANGINA-PECTORIS - ASPIRIN AND HE PARIN IN A DOUBLE-BLIND PLACEBO-CONTROLLED STUDY, THEIR EFFECTS ON THE OUTCOME OF DISEASE DURING HOSPITALIZATION

Aspirin and heparin are regarded as drugs that improve a prognosis in patients with unstable angina, but their comparative efficiency has no t been elucidated yet. A randomized double-blind placebo-controlled st udy of oral aspirin (165 mm once daily) versus intravenous infusion of heparin (1,000 units per hour) was carried out in 94 patients with ac ute unstable angina (the mean interval after the last anginal attack 5 .7+/-4.6 hours). During hospital stay, cardiac events (Q wave myocardi al infarction or cardiac death) developed in 6 out of 46 patients on a spirin and 6 out 48 patients on heparin. A significant superiority of heparin during its infusion (1 case of myocardial infarction versus 4 on aspirin) disappeared during the following 24 hours when 2 patients on heparin developed myocardial infarction (due to rebound phenomenon? ). Two patients on heparin underwent coronary artery bypass surgery. A mong complications only minor bleeding occurred. The results of this s tudy demonstrated no significant benefits of intravenous heparin infus ion over oral aspirin during hospitalization in patients with unstable angina. A high incidence (13 %) of poor outcomes observed with the tw o drugs indicates that it is necessary to search for more beneficial a ntithrombic interventions.