Key result
Intravenous nitroglycerin fails to alter heparin anticoagulation, leaving aPTT unchanged.
Why the study?
Conflicting results existed regarding whether intravenous nitroglycerin alters the anticoagulant effect of heparin as measured by aPTT.
Does intravenous nitroglycerin alter the anticoagulant effect of heparin in patients admitted for coronary angioplasty?
Observational (n=20)
No
Does intravenous nitroglycerin alter the anticoagulant effect of heparin in patients admitted for coronary angioplasty?
Concurrent administration of intravenous nitroglycerin does not significantly alter the anticoagulant effect of heparin as measured by aPTT in patients undergoing coronary angioplasty.
May not warrant heparin adjustment with nitroglycerin in angioplasty; leaves open interaction in larger randomized cohorts.
Nitroglycerin has been reported to reduce activated partial thromboplastin time (aPTT) values in patients treated with concurrent heparin and nitroglycerin. However, studies have yielded conflicting results. To determine whether intravenous nitroglycerin alters the anticoagulant effect of heparin, we prospectively evaluated twenty patients admitted for coronary angioplasty by measuring their aPTT both before initiation and after addition of nitroglycerin to heparin therapy. The results showed that the mean of aPTT at the baseline when patients were on heparin alone was not significantly different from aPTT measured upon addition of nitroglycerin, and 30 min following the cessation of nitroglycerin infusion, when patients were still on the same dose of heparin. Therefore, no direct effect of nitroglycerin on the anticoagulant effect of heparin was observed in this study.
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Mojtahedzadeh et al. (2005) conducted an observational in Coronary angioplasty (n=20). Intravenous nitroglycerin vs. Baseline (heparin alone) was evaluated on Activated partial thromboplastin time (aPTT) (p=0.61). Intravenous nitroglycerin did not significantly alter the anticoagulant effect of heparin, with mean aPTT remaining unchanged from baseline (92.75 sec) to peak nitroglycerin infusion (94.40 sec, p=0.61).
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