Different dose of heparin in preventing radial artery occlusion after transradial coronary angiography: A protocol for systematic review and meta-analysis of randomized controlled trials

Medicine (Baltimore). 2020 Nov 13;99(46):e23227. doi: 10.1097/MD.0000000000023227.

Abstract

Background: When atherosclerosis occurs in the coronary artery, resulting in stenosis, occlusion, or spasm of the coronary artery, the supply of blood and oxygen to the myocardium will be reduced or even unavailable, resulting in myocardial necrosis and heart pain, chest tightness, dyspnea and other symptoms caused by myocardial necrosis are collectively referred to as coronary atherosclerotic heart disease. Coronary angiography can not only understand the degree of coronary artery damage, but also estimate the prognosis of coronary artery stenting, which provides a reliable reference for clinical treatment. Transradial coronary angiography (TCA) has the advantages of high success rate, small trauma, less complications, no bed rest, reduce hospital stay and other superiority, which accepted and used by physicians. Although the success rate of surgery is high, the postoperative complications will still affect the effect of surgery and the prognosis of patients. The main manifestations are radial artery occlusion (RAO), forearm hematoma formation, pseudoaneurysm formation, periosteal compartment syndrome, radial artery perforation, etc. Among the many ways to prevent RAO, anticoagulant therapy with common heparin is one of them, but the dosage of heparin is not clear. Therefore, we decided to use systematic evaluation to evaluate the clinical effectiveness and safety of different dose of heparin in preventing of RAO, and to provide clinical basis for the early prevention and treatment of RAO.

Methods: Two reviewers independently searched PubMed, Embase, the Cochrance Library, Web of Science, Medline, CBM Disc, CNKI, and WANFANG Data to find the eligible research. The retrieval about the randomized controlled trials of different dose of heparin in preventing the occurrence of RAO after TCA in recent years. The retrieval time is set between January 1990 and June 2020. The retrieval language is Chinese/English. Two researchers independently searched, managed and screened the literature through the search terms. When the 2 parties have inconsistent opinions on the inclusion or not of certain literature, the literature will be referred to the third researcher for discussion and decision. The included studies are conducted bias risk assessment through bias risk assessment tool, which based on Cochrane Handbook 5.0. The extracted data uses RevMan5.3 software for statistical processing.

Results: The research results of this systematic review will be published in peer-reviewed medical-related academic journals.

Conclusion: This study adopts the Meta-analysis method and expands the sample size, which will give high-quality evidence-based medicine evidence on the clinical effectiveness and safety of different dose of heparin in preventing the occurrence of RAO.

Trial registration number: OSF, DOI 10.17605/OSF.IO/CPXJ3.

MeSH terms

  • Arterial Occlusive Diseases / etiology*
  • Arterial Occlusive Diseases / physiopathology
  • Clinical Protocols
  • Coronary Angiography / adverse effects*
  • Coronary Angiography / methods
  • Dose-Response Relationship, Drug*
  • Heparin / administration & dosage*
  • Heparin / therapeutic use
  • Humans
  • Meta-Analysis as Topic
  • Radial Artery / abnormalities*
  • Radial Artery / diagnostic imaging
  • Randomized Controlled Trials as Topic
  • Systematic Reviews as Topic
  • Treatment Outcome

Substances

  • Heparin