Taking aim at heart pain.

Taking aim at heart pain

Artery-clogging blood clots recently have been linked to a condition called unstable angina, a form of chest pain that may signal an impending heart attack. Now researchers report that angina patients benefit from treatment with heparin or aspirin, both of which inhibit clotting.

"We provided evidence that we could prevent myocardial infarction in these patients," says Pierre Theroux of the Montreal Heart Institute. Theroux and his colleagues studied 479 hospitalized patients who had experienced chest pain. Patients were put in four treatment groups, receiving aspirin, heparin, a combination of the two or a placebo.

Heparin therapy performed the best, reducing the rate of fatal and nonfatal heart attacks by 89 percent as compared with the placebo. Heparin also reduced chest pain by 63 percent, according to the research group's report in the Oct. 27 NEW ENGLAND JOURNAL OF MEDICINE. Previous studies of heparin treatment for chest pain have produced questionable results, Theroux says.

Aspirin therapy also helped. The Montreal team found aspirin reduced the risk of heart attacks by 72 percent as compared with the placebo -- a result that is consistent with previous research. But the combination aspirin/heparin treatment showed no particular benefit compared with aspirin alone or heparin alone, and patients getting the two drugs combined had a slightly higher risk of complications, such as bleeding.

For patients hospitalized with chest pain, the researchers recommend treatment with heparin upon admission followed by aspirin therapy for long-term management.