title: Effects of local heparin administration on coronary thrombin activity during percutaneous transluminal coronary angioplasty.
abstract: Simultaneously obtained blood samples from the coronary sinus and systemic arterial circulation were analyzed for antithrombin III (ATIII) activity and fibrinopeptide A (FpA) concentration in nine patients undergoing elective PTCA in order to determine the effects of locally delivered heparin. Samples were obtained at the following designated times: prior to the administration of systemic heparin (period I); 5 min following a loading dose of systemic heparin (period II); 5 min following the final balloon inflation but prior to local delivery (period III); and 5 min following the administration of 4,000 units of unfractionated heparin using a local delivery catheter system (period IV). We found consistent increases in both systemic arterial (P = 0.006) and coronary sinus (P = 0.0002) ATIII activity with systemic heparinization designed to prolong the activated clotting time to 300 sec. However, local delivery of heparin further increased coronary sinus ATIII activity (P = 0.003, period III vs. period IV). FpA concentration decreased in both systemic arterial (P < 0.0001) and coronary sinus (P < 0. 0001) samples following systemic heparinization. Moreover, local delivery of heparin further decreased coronary sinus FpA concentration (P = 0.04). Thus, on a background of intense anticoagulation during PTCA, the local delivery of 4,000 units of unfractionated heparin confers incremental antithrombotic activity. Cathet. Cardiovasc. Intervent. 48:84-88, 1999.
authors.affiliation: Division of Cardiology, University of Maryland School of Medicine and the Cardiac Catheterization Laboratories, University of Maryland Medical Systems, Baltimore, Maryland 21201, USA.
authors.forename: W K
authors.initials: WK
authors.lastname: Laskey
authors.forename: K
authors.initials: K
authors.lastname: Zawacki
authors.forename: R
authors.initials: R
authors.lastname: Lim
authors.forename: W
authors.initials: W
authors.lastname: Herzog
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage*; D000990:Antithrombin III / Q000032:analysis; D003331:Coronary Vessels; D005260:Female; D005344:Fibrinopeptide A / Q000032:analysis; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D013917:Thrombin / Q000032:analysis*; D014914:Whole Blood Coagulation Time
chemical_list: D000925:Anticoagulants; D005344:Fibrinopeptide A; D000990:Antithrombin III; D006493:Heparin; D013917:Thrombin