A RANDOMIZED TRIAL OF A FIXED HIGH-DOSE VS A WEIGHT-ADJUSTED LOW-DOSEOF INTRAVENOUS HEPARIN DURING CORONARY ANGIOPLASTY

Aims Prospectively to compare success rate and complications in percut aneous transluminal coronary angioplasty using two doses of heparin. M ethods and results Four hundred patients undergoing coronary angioplas ty were randomly assigned to receive 15 000 IU (group A) or 100 IU. kg (-1) (group B) of heparin. The angioplasty success rate was 95% in bot h groups. Stents were placed in 28.5% and 26.5% of patients in groups A and B, respectively (P=0.73). The primary endpoint (freedom from dea th, myocardial infarction, unplanned revascularization or bailout sten ting) occurred in 91% vs 95% of patients in groups A and B, respective ly (odds ratio: 1.88, 95% CI: 0.80-4.50, P=0.12). Haemoglobin loss was 0.36 +/- I and 0.27 +/- 0.9 g.dl(-1) in groups A and B, respectively (P=0.37). The time to sheath removal (735 +/- 265 vs 558 +/- 246 min) and the time to transfer to a stepdown unit (12.7 +/- 4.5 vs 9.8 +/- 4 .2 h) were longer in groups A (P=0.0001 for both comparisons). Conclus ion A weight-adjusted low dose of intravenous heparin is at least as s afe as a fixed high dose for coronary angioplasty. II allows earlier s heath removal and discharge to a stepdown unit.