Comparison of Effects of Low- versus High-Dose Heparin on Access-Site Complications during Transradial Coronary Angiography: A Double-Blind Randomized Study.
OBJECTIVE
Although heparin is highly effective in reducing the rate of radial artery occlusion after transradial catheterization, the optimal heparin dose is still controversial. The aim of this study was to evaluate the efficacy and safety of two different heparin doses during transradial coronary angiography.


METHODS
490 consecutive patients undergoing transradial coronary angiography were prospectively enrolled into this double-blind randomized trial. A total of 202 patients enrolled in the low-dose (LD; 2,500 U of heparin) group and 202 patients enrolled in the high-dose (HD; 5,000 U of heparin) group were included in the final analysis. The primary endpoint of the study was radial artery occlusion. Bleeding and hematomas were the secondary outcome measures.


RESULTS
At day 7, radial artery occlusion occurred in 5.9% of the patients in the LD group and in 5.4% of the patients in the HD group (p = 0.83). Bleeding during deflation of the transradial band occurred in 6.4% of the patients in the LD group and in 18.3% of the patients in the HD group; the difference was statistically significant (p < 0.001). Higher-dose heparin was found to be an independent predictor of bleeding (p = 0.007).


CONCLUSIONS
A lower dose of heparin (i.e. 2,500 U) decreases bleeding during transradial band deflation without an increase in radial artery occlusion.
Department of Cardiology, Acibadem University School of Medicine, Istanbul, Turkey.
Aleks
A
Degirmencioglu
Ali
A
Buturak
Ertugrul
E
Zencirci
Gultekin
G
Karakus
Tolga Sinan
TS
Güvenc
Ahmet
A
Akyol
Aycan
A
Esen
Yasemin
Y
Demirci
Ilke
I
Sipahi
Sinan
S
Dagdelen
Tugrul
T
Norgaz
Sevket
S
Gorgulu
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000517:prevention & control*; D017023:Coronary Angiography / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006406:Hematoma / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery / Q000187:drug effects*; D016896:Treatment Outcome
D000925:Anticoagulants; D006493:Heparin