Titre du document / Document title

Prolonged heparin after uncomplicated coronary interventions : A prospective, randomized trial

Auteur(s) / Author(s)

GARACHEMANI A. R. ⁽¹⁾ ; KAUFMANN U. ⁽¹⁾ ; FLEISCH M. ⁽¹⁾ ; MEIER B. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Cardiology, University Hospital, SUISSE

Résumé / Abstract

Background Continuous heparin infusion after percutaneous transluminal coronary angioplasty (PTCA) procedures prolongs the hospital stay and could increase the occurrence of bleeding complications. The aim of this randomized trial was to evaluate whether omission of heparin infusion after uncomplicated coronary interventions in patients with stable and unstable angina with or without stent implantation increased the incidence of acute cardiac complications. Methods and Results A total of 191 consecutive patients who underwent successful PTCA were randomly assigned to receive either prolonged heparin (heparin group) or no postprocedure heparin (control group). The 2 treatment groups were comparable with respect to clinical and angiographic characteristics. Stents were used in 36% of the control group and in 33% of the heparin group. Cardiac complications occurred in 8 (4%) patients. Four (4%) patients in the control group and 3 (3%) patients in the heparin group had a myocardial infarction. One patient in the control group died 3 days after the intervention. No patient in either group needed a repeat revascularization during the target hospitalization. Peripheral vascular complications in the control and heparin groups occurred in 1 % and 3% of the patients, respectively. Conclusions Omission of heparin after successful PTCA with or without stent implantation in patients with stable and unstable angina did not significantly increase the incidence of acute cardiac complications. It allows for early sheath removal and patient discharge and saves costs. This study, combined with other small studies in the field, provides strong evidence that heparin should not be used routinely.

Revue / Journal Title

The American heart journal   ISSN 0002-8703   CODEN AHJOA2 

Source / Source

1998, vol. 136, n^o2, pp. 352-356 (26 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1925) (Revue)

Mots-clés anglais / English Keywords

Heparin ; Long term ; Chemotherapy ; Instrumental dilatation ; Cuffed tube ; Coronary artery ; Comparative study ; Complication ; Treatment ; Prevention ; Treatment efficiency ; Withdrawal ; Ischemia ; Myocardium ; Human ; Glycosaminoglycan ; Anticoagulant ; Instrumentation therapy ; Cardiovascular disease ; Vascular disease ; Coronary heart disease ; Myocardial disease ;

Mots-clés français / French Keywords

Héparine ; Long terme ; Chimiothérapie ; Dilatation instrumentale ; Sonde ballonnet ; Artère coronaire ; Etude comparative ; Complication ; Traitement ; Prévention ; Efficacité traitement ; Arrêt traitement ; Ischémie ; Myocarde ; Homme ; Glycosaminoglycane ; Anticoagulant ; Traitement instrumental ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Cardiopathie coronaire ; Myocarde pathologie ;

Mots-clés espagnols / Spanish Keywords

Heparina ; Largo plazo ; Quimioterapia ; Dilatación instrumental ; Sonda en oliva ; Arteria coronaria ; Estudio comparativo ; Complicación ; Tratamiento ; Prevención ; Eficacia tratamiento ; Paro tratamiento ; Isquemia ; Miocardio ; Hombre ; Glicosaminoglicano ; Anticoagulante ; Tratamiento instrumental ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Cardiopatía coronaria ; Miocardio patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 2057, 35400007003933.0260