| Heparin dosing for percutaneous coronary angioplasty: use of body surface area to improve initial activated clotting time values. | |
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MedLine Citation:
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PMID: 9422838 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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G R Pesola; D A Pesola |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 20 ISSN: 0160-9289 ISO Abbreviation: Clin Cardiol Publication Date: 1997 Dec |
Date Detail:
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Created Date: 1998-02-03 Completed Date: 1998-02-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1006-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Marquette General Hospital, Michigan, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Anticoagulants; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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