Portal de Periódicos da CAPES

Effects of heparin and cardiac catheterization on serum lipoprotein and triglyceride levels

1994; Elsevier BV; Volume: 74; Issue: 1 Linguagem: Inglês

10.1016/0002-9149(94)90490-1

1879-1913

Gilbert A. Leidig, Richard C. Pasternak, Gary L. Horowitz, Geoffrey S. Ginsburg,

Acute Myocardial Infarction Research

This study determined whether heparin administration and procedures involving heparin significantly affect lipid measurement. Serum lipid and lipoprotein analyses (total cholesterol, triglycerides, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, apolipoprotein B, and apolipoprotein A-I) were performed at baseline and at several time points after (1) intravenous heparin or placebo in 6 healthy volunteers (group 1), (2) cardiac catheterization with heparin in 26 patients (group 2), and (3) peripheral angiography without heparin in 11 patients (group 3). In group 1, after heparinization, triglycerides decreased 50 ± 12 mg/dl (−57%, p < 0.001 vs baseline and placebo) at 60 minutes. No changes were observed in other lipid or lipoprotein fractions. After cardiac catheterization (group 2), however, decreases were observed not only in triglycerides (58 ± 26 mg/dl [−40%]), but also in total cholesterol (28 ± 12 mg/dl [−14%]), LDL cholesterol (19 ± 22 mg/dl [−15%]), apolipoprotein B (13 ± 9 mg/dl [−14%]), and apolipoprotein A-I (21 ± 14 mg/dl [−17%]) (p < 0.001 vs baseline for all), and HDL cholesterol (4 ± 7 mg/dl [−3%], p = 0.07). With the exception of triglycerides, these values remained significantly decreased for ≥24 hours. The change in HDL was variable: Whereas most patients had a decrease (n = 24), 2 patients had a dramatic increase (>100%) after administration of heparin. Similar decreases in total cholesterol, LDL cholesterol, and apolipoproteins B and A-I were observed in group 3 undergoing peripheral angiography without heparin. In contrast, triglycerides were unchanged and HDL decreased by 5 ± 3 mg/dl (−13%, p < 0.05 vs baseline). Cardiac catheterization, therefore, causes profound changes in serum lipids and lipoproteins that are due to a combination of the effects of heparin and the procedure.