Plasma Free Fatty Acids and the Incidence of Arrhythmias in Acute Myocardial Infarction during Treatment with Small Doses of Subcutaneous Heparin or Warfarin

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Abstract
In a prospective trial, 99 patients with a history of AMI [acute myocardial infarction] of less than 12 h were allocated at random to treatment with s.c. heparin [HP], 5000 IU twice daily, (51 patients) or warfarin [WF] (48 patients). In a subsample of 21 patients, 11 in the WF group and 10 in the heparin group, fasting FFA [free fatty acid] analyses were performed before and 2 h after administration of anticoagulants on days 1 and 2. No measurable increase in FFA concentrations was demonstrated in the HP-treated patients, in spite of a significant influence on the thrombin clotting time. The frequency of ventricular arrhythmias as detected by continuous tape recordings was equal in the 2 groups. S.c. HP, 5000 IU/12 h, can be administered to patients with AMI without increasing the risk of arrhythmias as compared with warfarin.