Current perspectives on British use of adjunctive therapies during coronary interventions

Background: Interventional techniques are commonly performed with adjunctiv e therapy including clopidogrel, ticlopidine, abciximab and heparin. We wis hed to assess the current British use of antiplatelet and anticoagulant age nts as adjunctive therapies in interventional cardiology in the light of th e available evidence base regarding their usage. Methods: A simple structur ed questionnaire was sent between August and October 1999 to all interventi onal cardiology consultants working in the UK regarding their usage of abci ximab (ReoPro), heparin, clopidogrel (Plavix) and ticlopidine (Ticlid) peri -procedurally. Results: 68% of consultants responded over the next 4 months , with many replying jointly for a centre rather than individually. Average abciximab use was 8.3% of interventional cases. Eighty-two percent of clin icians used clopidogrel in stented patients. Exact dosages varied considera bly. Fifty-three percent of clinicians gave 10 000 IU or more of heparin ro utinely. Conclusions: These figures are not in line with the published evid ence and British interventionists appear to have adopted various strategies to target the use of these agents. In particular, abciximab appears to be being administered reactively, as and when problems arise in the catheteris ation lab. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.