Do Opioid Addicts Require Higher Doses of Heparin During Percutaneous Coronary Intervention?

Document Type : Original Article

Authors

1 Student Research Committee, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

2 Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

3 Department of Medical Education, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

Abstract

Background: 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.

Methods: 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), partial 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.

Findings: 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).

Conclusion: Opioid addicts may require higher doses of heparin in PCI for the prevention of thrombotic 
complications compared to non-addicts.

Keywords

Addiction & Health
Volume 13, Issue 4
December 2021
Pages 242-8

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