PMID- 16368313
OWN - NLM
STAT- MEDLINE
DCOM- 20060331
LR  - 20131121
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 151
IP  - 1
DP  - 2006 Jan
TI  - A randomized pilot study of dalteparin versus unfractionated heparin during 
      percutaneous coronary interventions.
PG  - 175
AB  - BACKGROUND: Direct comparison of low-molecular-weight heparin, dalteparin, with 
      unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) is 
      limited. This study examined the relative effects of dalteparin and UFH on 
      coagulation and angiographic and clinical indices during PCI. METHODS: This was a 
      double-blind randomized study, stratified by planned glycoprotein IIb/IIIa 
      inhibitor use. Both UFH and dalteparin were administered as an intra-arterial 
      bolus immediately before PCI. RESULTS: All randomized patients received the 
      assigned study drug and underwent PCI. Mean activated clotting time levels were 
      344 seconds for UFH and 234 seconds for dalteparin (P < .0001). Anti-factor Xa 
      levels were higher for dalteparin at 30 minutes (UFH 1.3 IU/mL vs dalteparin 1.7 
      IU/mL, P = .005)) and at 4 hours (UFH 0.27 IU/mL vs dalteparin 0.69 IU/mL, P < 
      .0001). Angiographic success was > 90% in both groups, and angiographic 
      complications were similar (UFH 2.5% vs dalteparin 3.8%). The composite of death, 
      myocardial infarction, target vessel revascularization, or bailout glycoprotein 
      IIb/IIIa at hospital discharge was 13.7% in the UFH group and 13.1% in the 
      dalteparin group (P = not significant). There were 2 major bleedings requiring 
      transfusion, both occurring in the UFH group. CONCLUSIONS: This study suggests 
      that a single intra-arterial bolus of low-molecular-weight heparin without 
      monitoring is feasible and warrants further investigation as an alternative to 
      UFH during PCI.
FAU - Natarajan, Madhu K
AU  - Natarajan MK
AD  - Division of Cardiology, Department of Medicine, Hamilton Health Sciences, 
      McMaster University, Hamilton, Ontario, Canada. natarajm@ccc.mcmaster.ca
FAU - Velianou, James L
AU  - Velianou JL
FAU - Turpie, Alexander G G
AU  - Turpie AG
FAU - Mehta, Shamir R
AU  - Mehta SR
FAU - Raco, Dominic
AU  - Raco D
FAU - Goodhart, David M
AU  - Goodhart DM
FAU - Afzal, Rizwan
AU  - Afzal R
FAU - Ginsberg, Jeffrey S
AU  - Ginsberg JS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
CIN - Evid Based Cardiovasc Med. 2006 Jun;10(2):121-3. PMID: 16753524
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/*therapeutic use
MH  - Dalteparin/*therapeutic use
MH  - Double-Blind Method
MH  - Female
MH  - Heparin/therapeutic use
MH  - Humans
MH  - Intraoperative Care
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
EDAT- 2005/12/22 09:00
MHDA- 2006/04/01 09:00
CRDT- 2005/12/22 09:00
PHST- 2005/03/10 00:00 [received]
PHST- 2005/06/09 00:00 [accepted]
PHST- 2005/12/22 09:00 [pubmed]
PHST- 2006/04/01 09:00 [medline]
PHST- 2005/12/22 09:00 [entrez]
AID - S0002-8703(05)00632-0 [pii]
AID - 10.1016/j.ahj.2005.06.020 [doi]
PST - ppublish
SO  - Am Heart J. 2006 Jan;151(1):175. doi: 10.1016/j.ahj.2005.06.020.