Efficacy and safety of low dose heparin (30 IU/Kg) during coronary angioplasty

High doses of heparin are recommended during coronary angioplasty although platelet inhibition seems to play a role in the prevention of ischaemic com plications. Low dose heparin could reduce the incidence of local complicati ons without increasing that of major coronary events. The authors report the results of a prospective register of coronary angiop lasties performed by the femoral approach with a single bolus of 30 IU/Kg o f heparin and immediate withdrawal of the 6 French introducer. Only patient s with recent infarction or left main stem disease were excluded. All under went clinical examination and ultrasonic scanning of the puncture site the day after the procedure. Four hundred and eighteen patients were included (mean age: 63.3 +/- 11 yea rs;, 79% men; 77% stenting). The average dose of heparin was 2253 +/- 1056 IU; the average procedure time was 25 +/- 16 minutes, and a final activated clotting time was 174 +/- 69 ms. The duration of normal compression was 7. 7 +/- 3 min. Eighty-three point five per cent of patients were discharged t he day after the procedure with a global cardiovascular complication rate o f 2.87%. At 1 month, 1.67% of secondary cardiovascular events was recorded. Ultrasonography of the puncture site was abnormal in 7.6% of patients. Onl y one serious vascular complication (0.24%) requiring transfusion and surgi cal repair, was observed. The authors conclude that the use of low dose heparin appears effective and safe in cases without acute myocardial infarction. This protocol allows fa ster mobilisation and earlier hospital discharge of patients.