Afaghnia Tahereh, Nasim-Tajik Mohammad, Boushehri Elham, Nikparvar Marzieh, Gharibzade Abdollah, Farshidi Hossein
Student Research Committee, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Addict Health. 2021 Oct;13(4):242-248. doi: 10.22122/ahj.v13i4.1198.
Patients who undergo percutaneous coronary intervention (PCI) receive anticoagulants, most commonly heparin to prevent thrombotic events during the procedure. Opioid addicts may require higher doses of heparin for PCI. We aimed to compare the effect of heparin on activated clotting time (ACT) between opioid addicts and non-addicts prior to and during PCI.
This comparative study included 107 patients scheduled for elective PCI, of whom 50 were opioid addicts and 57 non-addicts. Patients' baseline characteristics including age, gender, weight, comorbidities, drug history, and smoking were recorded. Prothrombin time (PT), ýpartial thromboplastin time (PTT), international normalized ratio (INR), and platelet count were measured in venous blood samples collected from all participants. All patients underwent PCI through femoral access. They received 100 IU/kg heparin right at the beginning of the procedure. ACT was measured at 2 and 30 minutes.
Age, gender, weight, and the amount of heparin used were comparable between groups. As for general characteristics, the number of patients with hyperlipidemia was significantly higher in non-addicts (P = 0.031), and cigarette smoking was higher in opioid addicts (P < 0.001). No significant difference was found between the groups regarding PT, PTT, INR, and platelet count (P > 0.050). ACT at 2 and 30 min were significantly lower in opioid addicts (P < 0.001). Taking other variables into account, ACT at 2 min was directly correlated with drug history of aspirin in opioid addicts (P = 0.031) and inversely correlated with cigarette smoking in non-addicts (P = 0.023).
Opioid addicts may require higher doses of heparin in PCI for the prevention of thrombotic complications compared to non-addicts.
接受经皮冠状动脉介入治疗（PCI）的患者会使用抗凝剂，最常用的是肝素，以预防手术过程中的血栓形成事件。阿片类药物成瘾者在接受PCI时可能需要更高剂量的肝素。我们旨在比较阿片类药物成瘾者和非成瘾者在PCI术前及术中肝素对活化凝血时间（ACT）的影响。
这项比较研究纳入了107例计划接受择期PCI的患者，其中50例为阿片类药物成瘾者，57例为非成瘾者。记录患者的基线特征，包括年龄、性别、体重、合并症、用药史和吸烟情况。在所有参与者采集的静脉血样本中测量凝血酶原时间（PT）、部分凝血活酶时间（PTT）、国际标准化比值（INR）和血小板计数。所有患者均通过股动脉途径接受PCI。在手术开始时，他们接受100 IU/kg的肝素。在2分钟和30分钟时测量ACT。
两组之间的年龄、性别、体重和肝素使用量具有可比性。在一般特征方面，非成瘾者中高脂血症患者的数量显著更高（P = 0.031），而阿片类药物成瘾者的吸烟率更高（P < 0.001）。两组在PT、PTT、INR和血小板计数方面未发现显著差异（P > 0.050）。阿片类药物成瘾者在2分钟和30分钟时的ACT显著更低（P < 0.001）。考虑其他变量后，阿片类药物成瘾者在2分钟时的ACT与阿司匹林用药史直接相关（P = 0.031），而非成瘾者在2分钟时的ACT与吸烟呈负相关（P = 0.023）。
与非成瘾者相比，阿片类药物成瘾者在PCI中可能需要更高剂量的肝素以预防血栓形成并发症。
