Effect of heparin administration during coronary angiography on vascular or peripheral complications: a single-blind randomized controlled clinical trial

Background: Coronary angiography consists of the selective injection of contrast agents in coronary arteries. Optimal strategy for heparin administration during coronary angiography has yet to be determined. We assessed the effect of heparin administration during coronary angiography on vascular, hemorrhagic, and ischemic complications

Methods: Five hundred candiates for diagnostic coronary angiography [femoral approach] were randomly divided into case [intravenous Heparin [2000-3000 units]] and control [placebo] groups. Assessment included vascular complications like groin hematoma, retroperitoneal hematoma, pseudoaneurysm, active hemorrhage, cerebral ischemia, and clot formation in the catheter or the sheath during angiography. Information was obtained about the patients' age, sex, and hypertension and diabetes mellitus history. Patients with severe peripheral vascular disease, aortic stenosis, history of coagulopathy, and angiography over 30 minutes were excluded

Results: Nine patients from each group were excluded. The remaining 482 patients included 285 [59.1%] men and 197 [40.9%] women. In the case group [n=241], 7 [2.9%] patients experienced active hemorrhage at the site of angiographic puncture, 2 [0.83%] developed groin hematoma, and 8 [3.32%] experienced clot formation during angiography, while the corresponding figures for the control group [n=241] were 3 [1.24%], 2 [083%], and 13 [5.39%], respectively. No significant differences were found in hemorrhagic, ischemic, and vascular complications between the two groups

Conclusion: Heparin administration during coronary angiography had no effect on clot formation as well as hemorrhagic, ischemic, and vascular complications in our patients

Is reducing ovarian volume in polycystic ovarian syndrome patients after administration of metformin associated with improving cardiovascular risk factors?

Women with polycystic ovary syndrome [PCOS] are at increased risk for cardiovascular [CV] and metabolic disorders. There is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy. In randomized trials, the administration of metformin has been shown to be followed by an improvement in insulin sensitivity and decrease in androgen levels in most women. In the present study, we investigate the association between reduced ovarian volume in PCOS patients after administration of metformin with improvement in CV risk factors. This was a randomized clinical trial study. A total of 28 women diagnosed with PCOS who referred to the infertility clinic were selected. Anthropometric characteristics of the patients, mean ovarian volume and plasma levels of fasting blood sugar [FBS], lipid profile, luteinizing hormone [LH], follicle stimulating hormone [FSH], estradiol, testosterone, 17-alpha-OH progesterone [17OHP], dehydroepiandrosterone sulfate [DHEAS], C-reactive protein [CRP] and homocysteine [Hcy] were evaluated before and after treatment with 500 mg metformin, three times daily for three months. Statistics were calculated with the aid of SPSS 16.0 with student's paired t-and Pearson's correlation coefficient tests. Significance was set at p<0.05. There were significant reductions in mean ovarian volume and body mass index [BMI], in addition to CRP, Hcy, testosterone, FBS, HDL and LDL levels. There was a positive correlation between mean ovarian volume and waist-to-hip ratio [WHR]. After treatment, there correlation noted with reduction in mean ovarian volume and decreased BMI, in addition to reductions in CRP, LDL, Hcy and testosterone levels. A positive correlation may exist between reduced mean ovarian volume and improvement in CV risk factors after administration of metformin [Registeration Number: IRCT138903244176N1]