PMID- 23065322
OWN - NLM
STAT- MEDLINE
DCOM- 20140117
LR  - 20211021
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 36
IP  - 1
DP  - 2013 Jul
TI  - How one academic medical center has managed potency changes with unfractionated 
      heparin.
PG  - 91-5
LID - 10.1007/s11239-012-0810-y [doi]
AB  - The United States Pharmacopeia recently changed the standards for unfractionated 
      heparin (UFH) resulting in reduction in potency by about 10 %. Despite the 
      reduction in potency, no new recommendations for UFH dosing were recommended. A 
      retrospective review was conducted on patients receiving UFH and at least one 
      activated partial thromboplastin time (aPTT) after start of infusion. Patients 
      receiving UFH prior to April 2010 were collected as old UFH potency patients 
      versus those receiving UFH after May 1st, 2010 were defined as new UFH potency 
      patients. The primary endpoint was time to a therapeutic aPTT. Secondary 
      endpoints included the number venous thrombotic events (VTE) and bleeding events 
      during hospitalization through 30 days post discharge. Thrombotic events were 
      defined as acute coronary syndrome, ischemic stroke, and VTE. Bleeding was 
      defined in accordance with the GUSTO bleeding scale. A total of 359 patients were 
      included for evaluation, 181 in the old UFH group and 178 in the new UFH group. 
      The primary endpoint was similar between groups with an average time of 
      18.8 +/- 25.4 versus 20.8 +/- 22.2 h in the old and new UFH groups respectively 
      (p = 0.092). Patients receiving old UFH and an initial bolus had higher aPTTs 
      (96.6 +/- 43.7 s) than those receiving new UFH and an initial bolus (76.7 +/- 34.5 s) 
      (p = 0.003). There was no difference found between groups in regards to bleeding 
      or thrombotic events during hospitalization or through 30 days. In patients 
      receiving UFH, dosed per the institutions' nomogram, no clinically significant 
      outcomes were found between the old and new UFH potencies.
FAU - Lalama, Jeffery
AU  - Lalama J
AD  - Regis University School of Pharmacy, 3333 Regis Boulevard, Mail Code: H-28, 
      Denver, CO 80221-1099, USA.
FAU - Lewis, Patrick M
AU  - Lewis PM
FAU - Gore, Joel
AU  - Gore J
FAU - Tran, Maichi T
AU  - Tran MT
FAU - Donovan, Jennifer
AU  - Donovan J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Coronary Syndrome/chemically induced/epidemiology
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*administration & dosage/*adverse effects
MH  - Brain Ischemia/chemically induced/epidemiology
MH  - Female
MH  - Hemorrhage/chemically induced/epidemiology
MH  - Heparin/*administration & dosage/*adverse effects
MH  - Hospitalization
MH  - *Hospitals, University
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - Stroke/chemically induced/epidemiology
MH  - *Trauma Centers
MH  - United States
MH  - Venous Thrombosis/chemically induced/epidemiology
EDAT- 2012/10/16 06:00
MHDA- 2014/01/18 06:00
CRDT- 2012/10/16 06:00
PHST- 2012/10/16 06:00 [entrez]
PHST- 2012/10/16 06:00 [pubmed]
PHST- 2014/01/18 06:00 [medline]
AID - 10.1007/s11239-012-0810-y [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2013 Jul;36(1):91-5. doi: 10.1007/s11239-012-0810-y.