A randomized trial of a fixed high dose vs a weight-adjusted low dose of intravenous heparin during coronary angioplasty

Eur Heart J. 1997 Apr;18(4):631-5. doi: 10.1093/oxfordjournals.eurheartj.a015308.

Abstract

Aims: Prospectively to compare success rate and complications in percutaneous transluminal coronary angioplasty using two doses of heparin.

Methods and results: Four hundred patients undergoing coronary angioplasty were randomly assigned to receive 15,000 IU (group A) or 100 IU.kg-1 (group B) of heparin. The angioplasty success rate was 95% of both groups. Stents were placed in 28.5% and 26.5% of patients in groups A and B, respectively (P = 0.73). The primary endopoint (freedom from death, myocardial infarction, unplanned revascularization or bailout stenting) occurred in 91% vs 95% of patients in groups A and B, respectively (odds ratio: 1.88, 95% CI: 0.80-4.50, P = 0.12). Haemoglobin loss was 0.36 +/- 1 and 0.27 +/- 0.9 g.dl-1 in groups A and B, respectively (P = 0.37). The time to sheath removal (735 +/- 265 vs 558 +/- 246 min) and the time to transfer to a stepdown unit (12.7 +/- 4.5 vs 9.8 +/- 4.2 h) were longer in groups A (P = 0.0001 for both comparisons).

Conclusion: A weight-adjusted low dose of intravenous heparin is at least as safe as a fixed high dose for coronary angioplasty. It allows earlier sheath removal and discharge to a stepdown unit.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Angioplasty, Balloon, Coronary*
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Coronary Disease / therapy*
  • Dose-Response Relationship, Drug
  • Female
  • Heparin / administration & dosage*
  • Heparin / adverse effects
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Premedication
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin