Hemorrhagic complications of intravenous heparin use

• Published in: The American journal of cardiology 1997-07, Vol.80 (2), p.150-154
• Main Authors: JUERGENS, C. P, SEMSARIAN, C, KEECH, A. C, BELLER, E. M, HARRIS, P. J
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cardiovascular disease; Drug therapy; Drug toxicity and drugs side effects treatment; Female; Hemoglobins; Hemorrhage; Hemorrhage - chemically induced; Heparin - adverse effects; Humans; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Multivariate Analysis; Pharmacology. Drug treatments; Prospective Studies; Risk Factors; Sex Factors; Thrombocytopenia - chemically induced; Thrombolytic Therapy; Toxicity: blood
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/s0002-9149(97)00309-3

To document the incidence of bleeding complications occurring in patients admitted to a cardiology service treated with intravenous heparin and to identify the major risk factors for these adverse events. Intravenous heparin is effective treatment for a variety of cardiologic conditions but is associated with a number of adverse effects, including hemorrhage. During the study, 1,253 consecutive patients were admitted for acute cardiac care and of these, 416 were treated with intravenous heparin. A total of 39 complications occurred in 37 heparin-treated patients (8.9%), of which 23 were hemorrhagic complications occurring in 21 heparin-treated patients (5.5%). Of these hemorrhagic complications, 12 were directly related to a vascular access site and 11 were apparently "spontaneous" hemorrhages. There was no apparent relation between the dose (mean 1,021 U/hour [range 531 to 1,882]) or duration (6.7 +/- 5.7 days) of heparin therapy and hemorrhagic complications. In a multivariate analysis, female gender (odds ratio [OR] 4.76 [14.39 to 1.56]; p = 0.006), recent thrombolytic therapy (OR 12.9 [4.1 to 40.6]; p