Does nitroglycerin induce heparin resistance?

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Abstract
We studied the possibility that intravenous nitroglycerin may produce heparin resistance both in vitro and prospectively in a group of 10 patients following coronary angioplasty. Nitroglycerin in physiologic to pharmacologic concentrations (41-250 μg/ml) did not produce heparin resistance in vitro as measured by activated partial thromboplastin time and thrombin time. The maximum reduction in activated partial thromboplastin time was 7%. In patient studies, the activated partial thromboplastin time at baseline on heparin alone (93±22 s) was not significantly different (p=0.61) from activated partial thromboplastin measured upon addition of nitroglycerin (94±27 s) or 30 min following cessation of the nitroglycerin infusion while continuing the same dose of heparin (91±24 s). We conclude that intravenous nitroglycerin does not induce heparin resistance in vitro or in patients during short-term administration.