PMID- 19770793
OWN - NLM
STAT- MEDLINE
DCOM- 20110301
LR  - 20181201
IS  - 1536-3686 (Electronic)
IS  - 1075-2765 (Linking)
VI  - 17
IP  - 6
DP  - 2010 Nov-Dec
TI  - Safety and efficacy of prolonged use of unfractionated heparin after percutaneous 
      coronary intervention.
PG  - 535-42
LID - 10.1097/MJT.0b013e3181b63f05 [doi]
AB  - The current guidelines for percutaneous coronary intervention do not address the 
      prolonged postprocedural use of unfractionated heparin (UFH) to prevent acute 
      occlusion. However, recently published small studies have yielded mixed results, 
      leaving the question unanswered. Hence, we performed a meta-analysis of the 
      existing evidence to assess the safety and efficacy of prolonged infusion of UFH 
      after percutaneous coronary intervention. A systematic review of literature 
      revealed seven studies involving 2412 patients. End points analyzed were ischemic 
      complications (acute closure, myocardial infarction, and repeat 
      revascularization) and major vascular complications (hematoma, arteriovenous 
      fistula, pseudoaneurysm, and retroperitoneal bleed). Because the studies were 
      homogenous for outcomes, combined relative risks across all the studies and the 
      95% confidence intervals were computed using the Mantel-Haenszel fixed-effect 
      model. A two-sided alpha error <0.05 was considered to be statistically 
      significant. There were no significant differences in patient demographics 
      between both groups. Compared with placebo, the risk of major vascular 
      complication was significantly higher in patients getting postprocedural UFH for 
      prolonged hours (relative risk, 2.24; confidence interval, 1.68-3.48; P = 0.001). 
      However, the risk of ischemic complications was similar in both groups (relative 
      risk, 0.95; confidence interval, 0.46-1.96; P = 0.89). The meta-analysis suggests 
      that routine infusion of UFH after uncomplicated percutaneous coronary 
      intervention may result in increased vascular complications without any reduction 
      in incidence of ischemic complications.
FAU - Singh, Param Puneet
AU  - Singh PP
AD  - Section of Cardiology, Department of Internal Medicine, Chicago Medical 
      School/Rosalind Franklin University of Medicine and Science, North Chicago, IL 
      60064, USA. drparamsingh@gmail.com
FAU - Arora, Rohit
AU  - Arora R
FAU - Singh, Mukesh
AU  - Singh M
FAU - Bedi, Updesh Singh
AU  - Bedi US
FAU - Adigopula, Sasikanth
AU  - Adigopula S
FAU - Singh, Sarabjeet
AU  - Singh S
FAU - Bhuriya, Rohit
AU  - Bhuriya R
FAU - Molnar, Janos
AU  - Molnar J
FAU - Khosla, Sandeep
AU  - Khosla S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/*administration & dosage/*adverse effects/therapeutic use
MH  - Coronary Occlusion/prevention & control
MH  - Endpoint Determination
MH  - Heparin/*administration & dosage/*adverse effects/therapeutic use
MH  - Humans
MH  - Treatment Outcome
EDAT- 2009/09/23 06:00
MHDA- 2011/03/02 06:00
CRDT- 2009/09/23 06:00
PHST- 2009/09/23 06:00 [entrez]
PHST- 2009/09/23 06:00 [pubmed]
PHST- 2011/03/02 06:00 [medline]
AID - 10.1097/MJT.0b013e3181b63f05 [doi]
PST - ppublish
SO  - Am J Ther. 2010 Nov-Dec;17(6):535-42. doi: 10.1097/MJT.0b013e3181b63f05.