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European Heart Journal 1992 13(3):411-414;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Absence of nitroglycerin-induced heparin resistance in healthy volunteers

R. A. SCHOENENBERGER*,, L. MÉNAT{dagger}, P. WEISS*, G. A. MARBET{dagger} and R. RITZ*

*Departement of Internal Medicine, Division of Intensive Care University Hospital (Kantonsspital) 4051-Basel, Switzerland
{dagger}Departement of Internal Medicine, Coagulation Laboratory, University Hospital (Kantonsspital) 4051-Basel, Switzerland

Received 1 October 1990; revised 10 April 1991; .

Correspondence R. A. Schoenenberger, MD. Departement of Internal Medicine. Uniersity Hospital. Petersgraben 4. CH-4051 Basel Switzerland

Abstract

A previously described nitroglycerin-induced heparin resistance could not be verified by in-vitro experiments or in a randomized, double-blind, crossover trial in healthy volunteers. A clinically relevant attenuation of the anticoagulant effect of a heparin bolus (40 U.kg–1) by a concomitant infusion of nitroglycerin (100 µg.min–1) was absent. Activated partial thromboplastin time was not significantly different under nitroglycerin infusion as compared to placebo after heparin injection. Concentrations and activities of antithrombin III and heparin cofactor II remained unchanged during nitroglycerin infusion. An interaction of these two frequently combined drugs in patients with active thromboembolic disease or after a prolonged concomitant intravenous administration cannot be ruled out. Since this is of clinical importance, furt her studies must clarify a possible nitroglycerin-induced heparin resistance.

Key Words: Heparin • intravenous nitroglycerin • drug interaction • heparin-resistance


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