PROLONGED HEPARIN AFTER UNCOMPLICATED CORONARY INTERVENTIONS - A PROSPECTIVE, RANDOMIZED TRIAL

Background continuous heparin infusion after percutaneous transluminal coronary angioplasty (PTCA) procedures prolongs the hospital stay and could increase the occurrence of bleeding complications. The aim of t his randomized trial was to evaluate whether omission of heparin infus ion after uncomplicated coronary interventions in patients with stable and unstable angina with or without stent implantation increased the incidence of acute cardiac complications. Methods and Results A total of 191 consecutive patients who underwent successful PTCA were randoml y assigned to receive either prolonged heparin (heparin group) or no p ostprocedure heparin (control group). The 2 treatment groups were comp arable with respect to clinical and angiographic characteristics. Sten ts were used in 36% of the control group and in 33% of the heparin gro up. Cardiac complications occurred in 8 (4%) patients. Four (4%) patie nts in the control group and 3 (3%) patients in the heparin group had a myocardial infarction. One patient in the control group died 3 days after the intervention. No patient in either group needed a repeat rev ascularization during the target hospitalization. Peripheral vascular complications in the control and heparin groups occurred in 1% and 3% of the patients, respectively. Conclusions omission of heparin alter s uccessful PTCA with or without stent implantation in patients with sta ble and unstable angina did not significantly increase the incidence o f acute cardiac complications, It allows For early sheath removal and patient discharge and saves costs. This study combined with other smal l studies in the field, provides strong evidence that heparin should n ot be used routinely.