EM:RAP Emergency Medicine: Reviews and Perspectives

2012  ›  June Episode

Mini Journal Club: Heparin

Lots of data, some old and some new exists for the use of Heparin in ACS.. David rifled through all of it for this mini journal club segment. Maybe not ALL of it, but a lot of it and he did it for you!

Contributor

  • David Newman, MD

Comments on Mini Journal Club: Heparin

Henry S.

I really did not understand much of what he was saying as multiple times he spoke of preventing MI in NSTEMI patients. These patients are already having an MI. Did he mean preventing a STEMI? Did he mean preventing further troponin rise? I am no more clear on what the literature shows, although now I Suppose I should go read it for myself.

mark g.

that's a good point. Also, there's a couple of other reasons why delaying MI or progression of MI may be beneficial that he kindof brushed over. 1) If it buys time to get to cath or even bypass for defnitive opening of the coronary vessels, this may be a good thing. So perhaps we should strongly consider heparin in those pt's who we estimate having a high chance of being cathed that admission. 2) (less patient oriented, more doctor oriented) If the pt progresses to MI in 24 hours, that is medical/legally the responsibility of the initial treating physician. If the patient progresses to MI in 30 days, that's out of our window. I know that is slightly cynical but this is the world we live in.

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