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Lower-dose heparin use during coronary procedure does not appear to reduce risk of major bleeding
Date:8/31/2010

Patients with acute coronary syndromes initially treated with the anticoagulant fondaparinux who underwent a coronary procedure (such as balloon angioplasty) and received a lower dose of the anticoagulant heparin during the procedure did not have a reduced rate of major bleeding and vascular access site complications, according to a study that will appear in the September 22 issue of JAMA. The study is being released early online to coincide with its presentation at the European Society of Cardiology meeting in Stockholm.

Previous study results suggested the use of unfractionated heparin as supplemental therapy at the time of percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) for patients with non-ST segment elevation (a certain pattern on an electrocardiogram) acute coronary syndromes (such as heart attack or unstable angina) who were treated with fondaparinux and undergoing PCI. But there is disagreement on the appropriate range of dosing of heparin during PCI for these patients, according to background information in the article. "The optimal dosing of unfractionated heparin should maintain the safety profile of fondaparinux but achieve adequate antithrombin effect to prevent catheter thrombus [blood clots]," the authors write.

Sanjit S. Jolly, M.D., of Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada, and colleagues with the Fondaparinux Trial With Unfractionated Heparin During Revascularization in Acute Coronary Syndromes (FUTURA)/OASIS-8 trial evaluated the safety of two dose regimens of adjunctive intravenous unfractionated heparin during PCI in high-risk patients. The randomized trial included 179 hospitals in 18 countries and involved 2,026 patients undergoing PCI within 72 hours, who were from a group of 3,235 high-risk patients with non-ST segment elevation acute coronary syndromes initially treated with fondapa
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Contact: Lillian Badzioch
badzioch@hhsc.ca
90-552-121-007-6090
JAMA and Archives Journals
Source:Eurekalert

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