The Efficacy of Low Molecular Weight Heparin in Combination with Aspirin Treatment for Elderly Patients with Unstable Angina
The efficacy of low molecular weight heparin combined with aspirin treatment in elderly patients with unstable angina was significant, showing marked improvement in 15 cases (28.8%) and 15 cases (30.0%), respectively (P < 0.01), indicating statistical significance. The effect of adding low molecular weight heparin and aspirin therapy to conventional treatment in elderly patients with unstable angina pectoris is very notable.
2.3 Adverse Reactions: In the control group, there were 4 cases (8.0%) with gum bleeding; discontinuation of aspirin led to the disappearance of symptoms, with no severe bleeding cases. In the treatment group, 10 cases experienced subcutaneous ecchymosis at the injection site; one hypertensive patient had cerebral hemorrhage requiring surgical treatment, and one heart failure patient had upper gastrointestinal bleeding after cessation of anticoagulant therapy (bleeding incidence rate after hemostasis control was 23.1%). P < 0.05, which has statistical significance, indicating that the use of low molecular weight heparin and aspirin therapy based on conventional treatment increases the risk of bleeding in elderly patients with unstable angina pectoris.
2.4 Changes in HI Indicators Before and After Treatment in the Treatment Group are Shown in Table 2. Table 2 shows changes in blood clotting indices before and after treatment (i ± s). The pathophysiological basis of unstable angina is currently considered to be secondary pathological changes from unstable atherosclerotic plaques, such as coronary atherosclerosis plaque rupture, platelet aggregation, occlusive or non-occlusive thrombus formation, or stimulation of coronary artery spasm, leading to ischemic angina. Anticoagulant therapy is an optional treatment. The combination of low molecular weight heparin and aspirin in treating uAP significantly shortens the duration of angina, with a chest pain response rate of 98.1%, and improves ischemic changes on the ECG better than the control group. This is because low molecular weight heparin has high anti-factor Xa and antithrombin activity, reducing thrombin-induced platelet aggregation force, and can significantly lower fibrinogen levels in patients with UAP, demonstrating obvious anti-thrombosis effects. Additionally, using low molecular weight heparin plus aspirin prevents or mitigates disabled heparin rebound thrombin activity, reduces the incidence of acute cardiovascular events and bleeding side effects, partly compensating for the inadequacies of single low molecular weight heparin, thereby producing a better clinical effect. A large amount of clinical data shows that low molecular weight heparin only slightly extends AP1T with little effect on platelet count, without the need for laboratory monitoring. This study indicates that early application of low molecular weight heparin and aspirin treatment also mildly extends AP1T. However, it remains within the normal range before and after treatment, with no significant difference. But compared with the control group, bleeding events increased, including two serious bleeding events. The reasons may be: ① elderly patients with evident atherosclerosis and vascular fragility, complicated by easy bleeding in hypertension; ② elderly patients with heart failure often have gastrointestinal congestion, poor blood circulation in the gastrointestinal mucosa, combined with the role of aspirin on gastric mucosal injury, making them more prone to acute gastric mucosal lesions caused by gastrointestinal bleeding. Therefore, the use of low molecular weight heparin and aspirin therapy in elderly UAP is effective but increases the adverse effects of bleeding. However, the occurrence of these serious adverse reactions may be related to some underlying diseases in patients using low molecular weight heparin and aspirin therapy, thus presenting certain risk factors in elderly patients with UAP. Although there is no need to monitor blood clotting index changes, close clinical observation of bleeding adverse reactions is still necessary to avoid serious bleeding events.