Heparin dosing for percutaneous coronary angioplasty: use of body surface area to improve initial activated clotting time values

Clinical Cardiology
G R Pesola, D A Pesola

Abstract

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. 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. 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. 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 ...Continue Reading

References

Jan 1, 1992·Advances in Experimental Medicine and Biology·J Hirsh
Dec 1, 1989·Catheterization and Cardiovascular Diagnosis·J D OgilbyJ B Agarwal
Mar 1, 1981·Clinical Pharmacology and Therapeutics·R J CipolleE Haus
Jan 1, 1995·Catheterization and Cardiovascular Diagnosis·R S Blumenthal, J A Brinker
Apr 1, 1994·Journal of the American College of Cardiology·J J FergusonD R Leachman
Feb 1, 1996·Catheterization and Cardiovascular Diagnosis·G R PesolaD A Pesola

❮ Previous
Next ❯

Citations

Nov 11, 1998·The American Journal of Cardiology·J J PopmaR Piana

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.