New heparin dosing regimen for diabetics undergoing percutaneous coronary intervention.
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.
Lee
Michael S
MS
Cardiovascular Intervention Center, Cedars-Sinai Medical Center, 8631 W. Third Street, room 415E, Los Angeles, CA, USA. michael.lee@cshs.org
Rametta
Salvatore
S
Aragon
Joseph
J
Khan
Aslam
A
Wilentz
James
J
Singh
Varinder
V
Levitt
Howard
H
Kamra
Amit
A
Valania
Gregory
G
Makkar
Raj
R
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
D006495:Heparin, Low-Molecular-Weight; D019039:Platelet Glycoprotein GPIIb-IIIa Complex