Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events
Background. Rates of major bleeding and intraprocedural thrombotic events (IPTE) in the setting of percutaneous coronary intervention (PCI) using weight-adjusted unfractionated heparin (UFH) without activated clotting time (ACT) monitoring are not known. Methods. We reviewed 2,748 consecutive patien...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | International Journal of Clinical Practice |
| Online Access: | http://dx.doi.org/10.1155/2024/6219301 |
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| author | Ali Z. Zgheib Jennifer Jdaidani Elie Akl Suzan Khalil Omar Chaabo Nicolo Piazza Fadi J. Sawaya Abdallah G. Rebeiz |
| author_facet | Ali Z. Zgheib Jennifer Jdaidani Elie Akl Suzan Khalil Omar Chaabo Nicolo Piazza Fadi J. Sawaya Abdallah G. Rebeiz |
| author_sort | Ali Z. Zgheib |
| collection | DOAJ |
| description | Background. Rates of major bleeding and intraprocedural thrombotic events (IPTE) in the setting of percutaneous coronary intervention (PCI) using weight-adjusted unfractionated heparin (UFH) without activated clotting time (ACT) monitoring are not known. Methods. We reviewed 2,748 consecutive patients who underwent coronary angiography at our tertiary care university hospital between January 2017 and December 2020. All patients who underwent PCI with weight-adjusted UFH without ACT guidance were considered for further analysis. Major bleeding complications occurring within 48 hours of PCI were collected from patients’ medical records. IPTE were collected independently by two interventional cardiologists after review of coronary angiograms. Results. There were 718 patients included in the analysis (65.4 ± 12.2 years old; 81.3% male). In total, 45 patients (7.8%) experienced a major bleed or IPTE. The most common IPTE were slow/no reflow (1.5%) and coronary artery dissection with decreased flow (1.1%). Other IPTE occurred in <1% of cases. Major bleeding occurred in 11 patients (1.5%), of whom 8 required blood transfusion and 3 required vascular intervention. Bleeding complications were more common with femoral compared with radial access (6.6% vs. 0.2%, P<0.001). Conclusion. Weight-adjusted UFH use during PCI without ACT monitoring was related to low rates of major bleeding or IPTE. |
| format | Article |
| id | doaj-art-00a0119285da4b3a84d1843cdfcc7f0d |
| institution | OA Journals |
| issn | 1742-1241 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Clinical Practice |
| spelling | doaj-art-00a0119285da4b3a84d1843cdfcc7f0d2025-08-20T02:03:14ZengWileyInternational Journal of Clinical Practice1742-12412024-01-01202410.1155/2024/6219301Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding EventsAli Z. Zgheib0Jennifer Jdaidani1Elie Akl2Suzan Khalil3Omar Chaabo4Nicolo Piazza5Fadi J. Sawaya6Abdallah G. Rebeiz7American University of Beirut Medical CenterAmerican University of Beirut Medical CenterMcGill University Health CentreUniversity of California at Los AngelesAmerican University of Beirut Medical CenterMcGill University Health CentreAmerican University of Beirut Medical CenterAmerican University of Beirut Medical CenterBackground. Rates of major bleeding and intraprocedural thrombotic events (IPTE) in the setting of percutaneous coronary intervention (PCI) using weight-adjusted unfractionated heparin (UFH) without activated clotting time (ACT) monitoring are not known. Methods. We reviewed 2,748 consecutive patients who underwent coronary angiography at our tertiary care university hospital between January 2017 and December 2020. All patients who underwent PCI with weight-adjusted UFH without ACT guidance were considered for further analysis. Major bleeding complications occurring within 48 hours of PCI were collected from patients’ medical records. IPTE were collected independently by two interventional cardiologists after review of coronary angiograms. Results. There were 718 patients included in the analysis (65.4 ± 12.2 years old; 81.3% male). In total, 45 patients (7.8%) experienced a major bleed or IPTE. The most common IPTE were slow/no reflow (1.5%) and coronary artery dissection with decreased flow (1.1%). Other IPTE occurred in <1% of cases. Major bleeding occurred in 11 patients (1.5%), of whom 8 required blood transfusion and 3 required vascular intervention. Bleeding complications were more common with femoral compared with radial access (6.6% vs. 0.2%, P<0.001). Conclusion. Weight-adjusted UFH use during PCI without ACT monitoring was related to low rates of major bleeding or IPTE.http://dx.doi.org/10.1155/2024/6219301 |
| spellingShingle | Ali Z. Zgheib Jennifer Jdaidani Elie Akl Suzan Khalil Omar Chaabo Nicolo Piazza Fadi J. Sawaya Abdallah G. Rebeiz Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events International Journal of Clinical Practice |
| title | Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events |
| title_full | Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events |
| title_fullStr | Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events |
| title_full_unstemmed | Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events |
| title_short | Percutaneous Coronary Intervention with Procedural Unfractionated Heparin without Activated Clotting Time Guidance: A Unique Opportunity to Assess Thrombotic and Bleeding Events |
| title_sort | percutaneous coronary intervention with procedural unfractionated heparin without activated clotting time guidance a unique opportunity to assess thrombotic and bleeding events |
| url | http://dx.doi.org/10.1155/2024/6219301 |
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