[Effect of minidoses of heparin on the blood coagulation and thrombocytic links of hemostasis in myocardial infarct in middle-aged and elderly patients].

A study was made of the effect of moderate (300-500 units/kg per day) and minimum (200-250 units/kg per day) heparin doses in intravenous drop administration on the coagulation and thrombocytic links of hemostasis in 26 elderly and advanced age patients with myocardial infarction. The patients were divided into 2 groups: streptodecase and heparin were administered to the patients of the 1st group and heparin only was administered to the patients of the 2nd group. No significant effect of streptodecase on the hemocoagulation link of hemostasis with a low risk of developing hemorrhagic complications was noted. In 72-96 h of treatment intravenous heparin administration resulted in a decrease in a level of blood antithrombin III causing a decrease in the efficacy of heparin therapy. Control over a level of blood antithrombin III in addition to routine tests (thrombin time, thromboelastogram) provided an opportunity for adequate anticoagulant therapy. A negative effect of heparin on the thrombocytic link of hemostasis with deterioration of disaggregation properties and an increase in aggregation was noted. Antiaggregation therapy in parallel with the start of heparin administration was found necessary.