title: New heparin dosing regimen for diabetics undergoing percutaneous coronary intervention.
abstract: It has been previously demonstrated that diabetics are less sensitive to heparin compared to non-diabetics. We hypothesized that an initial heparin dose of 80 IU per kilogram administered to diabetics rather than 70 IU per kilogram might yield a more optimal initial ACT of 300 to 350 seconds when glycoprotein IIb/IIIa receptor antagonists are not used. We prospectively studied 130 elective PCI patients without diabetes treated with 70 IU per kilogram of unfractionated heparin and 81 elective PCI patients with diabetes treated with 80 IU per kilogram, and compared the initially achieved ACT. The mean heparin dose given per kg was greater (by intention) in diabetics versus non-diabetics. Despite that, there was no significant difference in the initially achieved ACT in diabetics and non-diabetics.
authors.affiliation: Cardiovascular Intervention Center, Cedars-Sinai Medical Center, 8631 W. Third Street, room 415E, Los Angeles, CA, USA. michael.lee@cshs.org
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: Salvatore
authors.initials: S
authors.lastname: Rametta
authors.forename: Joseph
authors.initials: J
authors.lastname: Aragon
authors.forename: Aslam
authors.initials: A
authors.lastname: Khan
authors.forename: James
authors.initials: J
authors.lastname: Wilentz
authors.forename: Varinder
authors.initials: V
authors.lastname: Singh
authors.forename: Howard
authors.initials: H
authors.lastname: Levitt
authors.forename: Amit
authors.initials: A
authors.lastname: Kamra
authors.forename: Gregory
authors.initials: G
authors.lastname: Valania
authors.forename: Raj
authors.initials: R
authors.lastname: Makkar
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000187:drug effects; D011336:Probability; D011446:Prospective Studies; D011859:Radiography; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome; D014914:Whole Blood Coagulation Time
chemical_list: D006495:Heparin, Low-Molecular-Weight; D019039:Platelet Glycoprotein GPIIb-IIIa Complex