Document Detail


Heparin dosing for percutaneous coronary angioplasty: use of body surface area to improve initial activated clotting time values.
MedLine Citation:
PMID:  9422838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Activated clotting time (ACT) values during percutaneous transluminal coronary angioplasty (PTCA) after the initial 10,000 U heparin bolus are often below target values of 350 or 400 s (Hemochron) and have to be supplemented with additional heparin. This study evaluated the initial 10 min post-heparin bolus clotting time value using a body surface area (BSA)-adjusted heparin bolus versus the traditional 10,000 U heparin bolus. HYPOTHESIS: Body surface area adjustment of initial heparin dosing prior to PTCA will be more effective in reaching target ACT values compared with the 10,000 U heparin bolus method. METHODS: Twenty-seven patients receiving the BSA-adjusted heparin bolus were compared with 27 age- and gender-matched controls who had received the traditional heparin bolus. The adjusted heparin bolus formula used was [BSA(m2)/1.3m2] x 10,000 U of heparin. RESULTS: The success rate at reaching the target value of 400 s was 13 of 27 (48.1%) and 2 of 27 (7.4%) for the BSA-guided and 10,000 U heparin-guided groups, respectively (p < 0.01). The success rate at reaching the 350 s target value was 25 of 27 (92.6%) and 6 of 27 (22.2%) for the BSA-guided and 10,000 U heparin-guided groups, respectively (p < 0.01). The 95% confidence intervals for the difference in success between the BSA-guided and 10,000 U heparin-guided groups were 0.19-0.62 and 0.52-0.89 for the 400 s and 350 s ACT targets, respectively. CONCLUSION: Body surface area adjustment of initial heparin dosing is a more effective method of reaching the initial ACT target values of 350 and 400 s compared with the traditional method prior to PTCA. This conclusion applies to the Hemochron ACT device and arterial samples, and adjustments may need to be made for other devices and/or venous samples.
Authors:
G R Pesola; D A Pesola
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  20     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-02-03     Completed Date:  1998-02-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1006-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Marquette General Hospital, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Anticoagulants / administration & dosage*,  therapeutic use
Blood Coagulation / drug effects*
Body Surface Area*
Coronary Disease / blood,  therapy
Female
Heparin / administration & dosage*,  therapeutic use
Humans
Infusions, Intravenous
Male
Middle Aged
Whole Blood Coagulation Time
Chemical
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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