PMID- 25841136
OWN - NLM
STAT- MEDLINE
DCOM- 20160225
LR  - 20150524
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 187
DP  - 2015
TI  - A comparison of low versus standard heparin dose for prevention of forearm artery 
      occlusion after 5 French coronary angiography.
PG  - 404-10
LID - S0167-5273(15)00624-5 [pii]
LID - 10.1016/j.ijcard.2015.03.366 [doi]
AB  - BACKGROUND: Radial artery occlusion (RAO) remains the Achilles' heel of 
      transradial coronary procedures. Standard over lower systemic anticoagulation 
      levels are believed to reduce RAO rates but this is ill-supported by scientific 
      evidence. We compared whether standard in comparison with less intensive 
      anticoagulation was superior in preventing vessel closure. METHODS AND RESULTS: 
      The two arms of this analysis included 731 pooled patients with the same 
      inclusion and exclusion criteria. We assessed forearm arterial access site 
      occlusion rate by unfractionated heparin (UFH) dose in an individual participant 
      data meta-analysis of this randomized study and of consecutive eligible patients 
      from our previous trial. We randomized 308 consecutive patients undergoing 
      transradial coronary angiography with 5 French (5 Fr) catheters without need to 
      crossover to receive 2500 or 5000 UFH units. The primary end-point was the 
      ultrasonographically determined vessel occlusion rate. Incident RAOs in the 
      randomized arm were 15.9% vs. 14%, in the low and standard UFH dose, respectively 
      (p=0.7). Corresponding figures for forearm arterial occlusion rates in the pooled 
      population were 13.0% vs. 9.9% (relative risk: 1.3, 95% confidence interval - CI: 
      0.88-1.98; p=0.2). Procedural and fluoroscopy duration was less than 15 and 3 
      min, respectively. The mean UFH dose difference was 3.52 (95% CI: -0.45 to 7.49) 
      units per kilo body weight between occluded (n=84) and patent forearm arteries 
      (n=647); (p=0.053). CONCLUSIONS: Incident forearm arterial occlusions were high 
      despite using 5 Fr catheters for a short-lasting procedure. Systemic 
      anticoagulation with standard over lower UFH dose did not reduce the frequency of 
      RAOs after coronary angiography.
CI  - Copyright (c) 2015. Published by Elsevier Ireland Ltd.
FAU - Hahalis, George
AU  - Hahalis G
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece. Electronic 
      address: hahalisg@yahoo.com.
FAU - Xathopoulou, Ioanna
AU  - Xathopoulou I
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Tsigkas, Grigorios
AU  - Tsigkas G
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Almpanis, George
AU  - Almpanis G
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Christodoulou, Ioannis
AU  - Christodoulou I
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Grapsas, Nikolaos
AU  - Grapsas N
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Davlouros, Periklis
AU  - Davlouros P
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Koniari, Ioanna
AU  - Koniari I
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Deftereos, Spyridon
AU  - Deftereos S
AD  - Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, 
      Greece.
FAU - Raisakis, Konstantinos
AU  - Raisakis K
AD  - Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, 
      Greece.
FAU - Christopoulou, Georgia
AU  - Christopoulou G
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Giannopoulos, George
AU  - Giannopoulos G
AD  - Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, 
      Greece.
FAU - Kounis, Nikolaos
AU  - Kounis N
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
FAU - Pyrgakis, Vlassis
AU  - Pyrgakis V
AD  - Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, 
      Greece.
FAU - Alexopoulos, Dimitrios
AU  - Alexopoulos D
AD  - Department of Cardiology, Patras University Hospital, Patras, Greece.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20150327
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*administration & dosage
MH  - Arterial Occlusive Diseases/etiology/*prevention & control
MH  - Catheters
MH  - Coronary Angiography/adverse effects/*instrumentation
MH  - Female
MH  - Forearm/blood supply
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - *Radial Artery
MH  - Single-Blind Method
OTO - NOTNLM
OT  - Anticoagulation
OT  - Arterial occlusion
OT  - Coronary angiography
OT  - Radial
EDAT- 2015/04/05 06:00
MHDA- 2016/02/26 06:00
CRDT- 2015/04/05 06:00
PHST- 2014/05/01 00:00 [received]
PHST- 2015/03/23 00:00 [revised]
PHST- 2015/03/25 00:00 [accepted]
PHST- 2015/04/05 06:00 [entrez]
PHST- 2015/04/05 06:00 [pubmed]
PHST- 2016/02/26 06:00 [medline]
AID - S0167-5273(15)00624-5 [pii]
AID - 10.1016/j.ijcard.2015.03.366 [doi]
PST - ppublish
SO  - Int J Cardiol. 2015;187:404-10. doi: 10.1016/j.ijcard.2015.03.366. Epub 2015 Mar 
      27.