Mean-term calcium heparin treatment in acute transmural anterior myocardial infarction: effects on left ventricular thrombosis and its complications.

In order to assess the efficacy of 3-month subcutaneous treatment with calcium heparin 12,500 IU twice daily in preventing left ventricular thrombosis and its complications a prospective, controlled, randomized trial was carried out in 204 patients with acute anterior myocardial infarction consecutively enrolled in seven Italian hospitals. Left ventricular thrombosis was diagnosed by means of two-dimensional echocardiography performed at baseline, after 10 and 90 days of treatment. The incidence of thrombosis at the baseline echocardiogram was not significantly different between the treatment and control groups, whereas a significantly lower incidence of thrombi was observed in treated than in control group both on day 10 (3/86, 3.5% and 13/85, 15.3%, respectively; p < 0.05) and day 90 (1/65, 1.5% and 6/57, 10.5%, respectively; p < 0.05). The total incidence of thrombi after 3 months of therapy was significantly lower in calcium heparin-treated patients (19/106, 17.9%) than in controls (31/98, 31.6%; p < 0.05). The incidence of cardiac events (death, reinfarction, angina) in the two groups during the 3-month treatment period was not significantly different. Two embolic events, one cerebral and one pulmonary, occurred in the control group, both after day 10 of treatment.