PMID- 26419985
OWN - NLM
STAT- MEDLINE
DCOM- 20160915
LR  - 20181202
IS  - 0253-3758 (Print)
IS  - 0253-3758 (Linking)
VI  - 43
IP  - 5
DP  - 2015 May
TI  - [Activated clotting time post therapeutic anticoagulation with unfractionated 
      heparin in patients undergoing elective percutaneous coronary intervention].
PG  - 408-12
AB  - OBJECTIVE: To investigate the activated clotting time (ACT) level after 
      administration of guideline-recommended dose of unfractionated heparin (UFH) and 
      to confirm the importance of ACT monitoring in percutaneous coronary intervention 
      (PCI). METHODS: We performed a retrospective study on 1 062 patients undergoing 
      elective PCI in Peking Union Medical College Hospital from May 1, 2011 to 
      December 31, 2012. All patients were administrated weight-adjusted UFH (70-100 
      U/kg) based on PCI guideline of ACCF/AHA/SCAI. Patients were divided into 3 
      groups: ACT < 300 s (598 cases), ACT 300-350 s (183 cases) and ACT > 350 s (281 
      cases). ACT level and factors that may affect UFH anticoagulation were analyzed. 
      RESULTS: (1) The mean age was (63.0 +/- 10.6) years and 751 (70.7%) patients were 
      men. The mean weight was (70.5 +/- 11.7) kg, and the mean UFH dose used was (100.7 
      +/- 9.1) U/kg. (2) The median ACT was 285 (240-352) s after the UFH use. 
      Pre-defined ACT target (300-350 s) was achieved only in 17.2% (183/1 062) 
      patients. (3) Age, gender, height, weight, UFH/weight and the risk factors of 
      coronary heart disease were similar among 3 groups (all P > 0.05). Multifactor 
      linear correlation analysis showed that UFH/weight was related to ACT level (r = 
      0.07, P < 0.01), but other factors were not related to ACT level (all P > 0.05). 
      (4) Among 598 patients with ACT < 300 s, 444 (74.2%) patients received additional 
      UFH. No major bleeding events were observed in 1 062 patients. The incidence of 
      minor bleeding and ischemic complications within 48 h after procedure were 
      similar among 4 groups of ACT < 300 s with additional UFH, ACT < 300 s without 
      additional UFH, ACT 300-350 s and ACT > 350 s (all P > 0.05). CONCLUSIONS: In 
      this single-center study, only a small proportion of patients reached the ACT 
      target after administration of weight-adjusted UFH. Our results supported the 
      recommendation of ACT monitoring in current PCI guideline to improve efficacy and 
      safety of UFH anticoagulation therapy.
FAU - Li, Jingyi
AU  - Li J
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Liu, Zhenyu
AU  - Liu Z
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Zhang, Shuyang
AU  - Zhang S
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China; 
      Email: shuyangzhang103@163.com.
FAU - Shen, Zhujun
AU  - Shen Z
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Fan, Zhongjie
AU  - Fan Z
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Zeng, Yong
AU  - Zeng Y
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Xie, Hongzhi
AU  - Xie H
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Wang, Chonghui
AU  - Wang C
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Jin, Xiaofeng
AU  - Jin X
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Fang, Quan
AU  - Fang Q
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
FAU - Zhu, Wenling
AU  - Zhu W
AD  - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Xin Xue Guan Bing Za Zhi
JT  - Zhonghua xin xue guan bing za zhi
JID - 7910682
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Coronary Disease
MH  - Female
MH  - Hemorrhage/epidemiology
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - *Whole Blood Coagulation Time
EDAT- 2015/10/01 06:00
MHDA- 2016/09/16 06:00
CRDT- 2015/10/01 06:00
PHST- 2015/10/01 06:00 [entrez]
PHST- 2015/10/01 06:00 [pubmed]
PHST- 2016/09/16 06:00 [medline]
PST - ppublish
SO  - Zhonghua Xin Xue Guan Bing Za Zhi. 2015 May;43(5):408-12.