Effect of Sublingual Heparin on Lipemia Clearing and on Recurrence of Myocardial Infarction

Fuller, Harvey L.

doi:10.1177/000331976001100308

Cited by 8 publications

(1 citation statement)

References 14 publications

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“…In five healthy individuals, a 40,000-unit dose of heparin powder swallowed in a gelatin capsule caused a prolonged decrease in triglycerides (15). Many years ago, sublingual heparin markedly decreased serum lipemia after a fat meal in human subjects (16). The author reported a significant (p < 0.01) decrease in recurrent myocardial infarcts using sublingual heparin in a controlled study.…”

Section: Discussionmentioning

confidence: 95%

Orally Ingested Heparin Is Absorbed in, Humans

Engelberg

1995

Clin Appl Thromb Hemost

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It has been accepted for many years that orally ingested heparin is not absorbed. Recent evidence has shown that heparin placed in the stomach of rats is very rapidly absorbed and that it also quickly and almost completely attaches to the vascular endothelium and prevents jugular vein thrombosis. Within 6 min, heparin was undetectable in the blood plasma. If a similar situation exists in humans, blood samples taken >15 min after heparin ingestion will lack evidence of anticoagulant activity. In this study, 45 individuals swallowed 20,000 units of heparin. Plasma activated partial thromboplastin time (APTT) levels were determined (in duplicate) before and at frequent intervals for 30 min after the heparin ingestion. There as a slightly prolonged APTT (range, 1-5 s) after swallowing the heparin. The average increase in the APTT was 2.3 s, which is statistically significant (p < 0.001), as the standard deviation of the method is .43 s. In several instances, frozen plasma aliquots, analyzed for heparin by a chromogenic method, showed its presence after ingestion. The preliminary results are important, although obviously oral heparin does not attain effective anticoagulant levels, as the many non-anticoagulant actions of heparin and the observation of its absorption after oral ingestion present numerous possibilities for new clinical applications. Key Words: Heparin—Oral absorption.Heparin is widely used as an anticoagulant. For this purpose, it is given intravenously or subcutan~ously. It i~ also used in srnaller, nonanticoagulant doses, given 2 to 3 times a week subcutaneously, to retard the progress of atherosclerotic disease and its complications. The need for injections has substantially limited this latter long-term application. If orally ingested heparin is absorbed and future studies show that it affords substantially the same benefits as inje~ted ~~~u-dc~se heparin, it could be much more widely applied preventively. &dquo;~'ears ag~, man3~ studies were published investigating the possibilities of administering heparin by routes other than injection. These summarized early findings (1) and were essentially contradictory and inconclusive. Occasionally trace anticoagulant or Mpolytic activity was found after large doses of heparin, but the results contrasted sharply with'the well-documented activity obtained with parenterally injected heparin, even in small amounts. Also was the heparin-like substances is intestinal mucosal preparations (Ateroid and Vessel) and in tracheal cartilage (chondrolitiln sulfates) were absorbed after oral ingestion and showed biologic activity. However, it has been generally believed that heparin is ineffective when given by mouth. Inhalation of ultrasonically nebulized heparin is effective but is cumbersome.However, recent studies in rats have clearly demonstrated that large amounts of aqueous solutions of heparin and dextran sulfate 8000 are rapidly absorbed from the stomach and almost immediately taken up by the vascular endothelium (2). It was shown that within 6 min after or...

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Section: Discussionmentioning

confidence: 95%