ESC: Low-Dose Heparin Doesn't Reduce PCI-Related Bleeding

Researchers recommend standard dose for non-ST-segment elevation patients
By Monica Smith
HealthDay Reporter

TUESDAY, Aug. 31 (HealthDay News) -- Compared with standard unfractionated heparin, low-dose unfractionated heparin does not appear to reduce peri-percutaneous coronary intervention (PCI) bleeding and vascular access-site complications in patients with non-ST-segment elevation acute coronary syndromes, according to research published online Aug. 31 in the Journal of the American Medical Association to coincide with the European Society of Cardiology Congress, held from Aug. 28 to Sept. 1 in Stockholm, Sweden.

Philippe Gabriel Steg, M.D., of the Université Paris 7, and colleagues analyzed data on 2,026 patients randomized to either low-dose (50 U/kg) or standard-dose (85 U/kg) unfractionated heparin during PCI. The researchers compared the rates of bleeding and vascular access-site complications between the groups, which consisted of non-ST-segment elevation acute coronary syndrome patients initially treated with fondaparinux.

The researchers found that the composite outcome of major or minor bleeding or major vascular access-site complications occurred in 4.7 percent of patients receiving a low dose of heparin, compared with 5.8 percent in the those receiving a standard dose (P = .27). Rates of major bleeding were similar between the two groups, though minor bleeding occurred in 0.7 percent in the low-dose group compared with 1.7 percent in standard-dose recipients (P = .04).

"Patients with acute coronary syndromes treated with fondaparinux and undergoing PCI should receive the guideline-recommended activated clotting time-guided standard dose of unfractionated heparin," the authors conclude.

Several authors disclosed financial relationships with pharmaceutical companies.

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