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Unfractionated heparin during elective PCI: Fixed dose or weight adjusted?

机译：选择性PCI期间未分级的肝素：固定剂量或重量是否已调整？

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Introduction: To assess two different dosing strategies of unfractionated heparin (UFH) during elective percutaneous coronary intervention (PCI). Aims: The optimal dose of heparin during elective PCI in patients with stable angina is unknown. Existing guidelines are based on limited data. We interrogated data from the PCI database. Patients with stable angina undergoing planned transradial PCI for uncomplicated single lesions were included. The main endpoint was troponin I release. We compared a fixed heparin dose (3000 U) UFH to a weight-adjusted dose. Results: Of 698 patients 244 (35.0%) received fixed dose (3000 U) and 454 (65.0%) 70 U/kg weight-adjusted UFH. There was no significant difference in median troponin between the fixed dose and the weight-adjusted groups; 0.17 ng/mL versus 0.14; P= 0.21. The proportion of troponin positive patients was similar in both groups (61.9% in the fixed dose group vs. 58.1%; P= 0.37). There were no deaths or major ischemic events during hospitalization. There was no bleeding requiring transfusion or delaying hospital discharge. Conclusion: In conclusion, this retrospective observational study of elective transradial PCI demonstrated that a reduced, fixed dose of periprocedural heparin was associated with similar postprocedural troponin levels when compared to a standard weight-adjusted regime. Our study further questions the optimal dose of heparin required during elective PCI and suggests a need for further trials.
机译：简介：评估选择性经皮冠状动脉介入治疗（PCI）期间普通肝素（UFH）的两种不同给药策略。目的：稳定型心绞痛患者择期PCI期间肝素的最佳剂量尚不清楚。现有准则基于有限的数据。我们查询了来自PCI数据库的数据。纳入了计划中的经lesions动脉PCI治疗的单纯性单一病变的稳定型心绞痛患者。主要终点是肌钙蛋白I释放。我们将固定肝素剂量（3000 U）UFH与体重调整剂量进行了比较。结果：在698例患者中，有244例（35.0％）接受了固定剂量（3000 U），而454例（65.0％）接受了70 U / kg体重调整后的UFH。固定剂量组和体重调整组之间的肌钙蛋白中位数无显着差异。 0.17 ng / mL对0.14; P ＝ 0.21。两组肌钙蛋白阳性患者的比例相似（固定剂量组为61.9％，而固定剂量组为58.1％; P = 0.37）。住院期间无死亡或重大缺血事件。没有出血需要输血或延迟出院。结论：总而言之，这项选择性trans动脉PCI的回顾性观察研究表明，与标准体重调整方案相比，减少的固定剂量的围手术期肝素与类似的术后肌钙蛋白水平相关。我们的研究进一步质疑了选择性PCI术中所需肝素的最佳剂量，并建议需要进一步试验。

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