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Unfractionated Heparin during Elective PCI: Fixed Dose or Weight Adjusted?

Lookup NU author(s): Dr Girish Viswanathan, Professor Azfar Zaman

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Abstract

Introduction: To assess two different dosing strategies of unfractionated heparin (UFH) during elective percutaneous coronary intervention (PCI). Aims: The optimal dose of heparin during elective PCI in patients with stable angina is unknown. Existing guidelines are based on limited data. We interrogated data from the PCI database. Patients with stable angina undergoing planned transradial PCI for uncomplicated single lesions were included. The main endpoint was troponin I release. We compared a fixed heparin dose (3000 U) UFH to a weight-adjusted dose. Results: Of 698 patients 244 (35.0%) received fixed dose (3000 U) and 454 (65.0%) 70 U/kg weight-adjusted UFH. There was no significant difference in median troponin between the fixed dose and the weight-adjusted groups; 0.17 ng/mL versus 0.14; P= 0.21. The proportion of troponin positive patients was similar in both groups (61.9% in the fixed dose group vs. 58.1%; P= 0.37). There were no deaths or major ischemic events during hospitalization. There was no bleeding requiring transfusion or delaying hospital discharge. Conclusion: In conclusion, this retrospective observational study of elective transradial PCI demonstrated that a reduced, fixed dose of periprocedural heparin was associated with similar postprocedural troponin levels when compared to a standard weight-adjusted regime. Our study further questions the optimal dose of heparin required during elective PCI and suggests a need for further trials.


Publication metadata

Author(s): Kidambi A, Mayurathan G, Viswanathan G, Schechter C, Zaman AG

Publication type: Article

Publication status: Published

Journal: Cardiovascular Therapeutics

Year: 2012

Volume: 30

Issue: 1

Pages: 1-4

Print publication date: 14/10/2010

ISSN (print): 1755-5914

ISSN (electronic): 1755-5922

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1111/j.1755-5922.2010.00231.x

DOI: 10.1111/j.1755-5922.2010.00231.x


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Funding

Funder referenceFunder name
FS/033/07British Heart Foundation

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