Document Detail


Anticoagulation therapy in intra-aortic balloon counterpulsation: does IABP really need anti-coagulation?
MedLine Citation:
PMID:  12958723     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate if intra-aortic balloon pump (IABP) is contraindicated without anticoagulation therapy. METHODS: Some 153 IABP patients in the King Abdulaziz Cardiac Center (KSA) were randomly assigned into two groups. Anticoagulation group (Group A) consisted of 71 patients who were given heparin intravenously with target aPTT 50-70 seconds. Non-anticoagulation group (Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products (FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded. RESULTS: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups (P<0.05). D-dimer and FDP level increased at 24 hours and 48 hours in both groups (P<0.05), but returned to the baseline level 24 hours post IABP removal (P>0.05). Three patients in Group A and 2 patients in Group B developed minor limb ischemia (P>0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B (P<0.05). No clot deposit developed on IABP surface in either group. CONCLUSION: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.
Authors:
Chen-yang Jiang; Li-li Zhao; Jian-an Wang; Balgaith Mohammod
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of Zhejiang University. Science     Volume:  4     ISSN:  1009-3095     ISO Abbreviation:  J. Zhejiang Univ. Sci.     Publication Date:    2003 Sep-Oct
Date Detail:
Created Date:  2003-09-05     Completed Date:  2004-06-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100954270     Medline TA:  J Zhejiang Univ Sci     Country:  China    
Other Details:
Languages:  eng     Pagination:  607-11     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China. jiangchenyang@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / therapeutic use*
Aorta / pathology*
Arteries
Blood Coagulation Tests
Counterpulsation
Female
Fibrinogen / biosynthesis
Humans
Intra-Aortic Balloon Pumping / methods*
Ischemia / pathology
Male
Middle Aged
Plasminogen Activator Inhibitor 1 / biosynthesis
Time Factors
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Plasminogen Activator Inhibitor 1; 9001-32-5/Fibrinogen

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