[Efficacy and safety of low-dose heparin (30 IU/kg) during coronary angioplasty].
High doses of heparin are recommended during coronary angioplasty although platelet inhibition seems to play a role in the prevention of ischaemic complications. Low dose heparin could reduce the incidence of local complications without increasing that of major coronary events. The authors report the results of a prospective register of coronary angioplasties performed by the femoral approach with a single bolus of 30 IU/Kg of heparin and immediate withdrawal of the 6 French introducer. Only patients with recent infarction or left main stem disease were excluded. All underwent clinical examination and ultrasonic scanning of the puncture site the day after the procedure. Four hundred and eighteen patients were included (mean age: 63.3 +/- 11 years; 79% men; 77% stenting). The average dose of heparin was 2253 +/- 1056 IU; the average procedure time was 25 +/- 16 minutes, and a final activated clotting time was 174 +/- 69 ms. The duration of normal compression was 7.7 +/- 3 min. Eighty-three point five per cent of patients were discharged the day after the procedure with a global cardiovascular complication rate of 2.87%. At 1 month, 1.67% of secondary cardiovascular events was recorded. Ultrasonography of the puncture site was abnormal in 7.6% of patients. Only one serious vascular complication (0.24%) requiring transfusion and surgical repair, was observed. The authors conclude that the use of low dose heparin appears effective and safe in cases without acute myocardial infarction. This protocol allows faster mobilisation and earlier hospital discharge of patients.
Godon
P
P
Service d'hémodynamique, hôpital cardiovasculaire et pneumologique Louis-Pradel, BP Lyon Montchat, 69394 Lyon.
Rioufol
G
G
Finet
G
G
Chirossel
P
P
de Gevigney
G D
GD
Roriz
R
R
Rossi
R
R
Fouët
X A
XA
Bonnefoy
E
E
Mc Fadden
E P
EP
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011183:Postoperative Complications / Q000517:prevention & control*
D000925:Anticoagulants; D006493:Heparin
Efficacité et sécurité d'emploi de faibles doses d'héparine (30 UI/kg) en cours d'angioplastie coronaire.