The high dose unfractionated heparin is related to less radial artery occlusion rates after diagnostic cardiac catheterisation: a single centre experience


BEŞLİ F., GÜNGÖREN F., TANRIVERDİ Z., Tascanov M. B., Fedai H., Akcali H., ...More

ACTA CARDIOLOGICA, vol.76, no.2, pp.168-174, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 76 Issue: 2
  • Publication Date: 2021
  • Doi Number: 10.1080/00015385.2019.1705584
  • Journal Name: ACTA CARDIOLOGICA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
  • Page Numbers: pp.168-174
  • Keywords: Transradial approach, radial artery occlusion, high dose heparin, standard dose heparin, CORONARY-ANGIOGRAPHY, PREVENTION, PATENCY, FLOW, COMPRESSION, IMPACT
  • Dokuz Eylül University Affiliated: No

Abstract

Background: Transradial approach (TRA) has increasingly become the default strategy for cardiac catheterisation. However, TRA can result in several complications; radial artery occlusion (RAO) is the most unwilling complication. Unfractionated heparin (UFH) is an effective therapy in preventing RAO. The goal of this study was to evaluate whether weight-adjusted high dose UFH reduces the rate of RAO after diagnostic cardiac catheterisation compared to weight-adjusted standard dose UFH. Methods: A total of 1215 patients screened and after exclusion criteria, 686 consecutive patients were enrolled. 100 IU/kg UFH (high dose UFH group) and 50 IU/kg UFH (standard dose UFH group) were given the patients undergoing diagnostic cardiac catheterisation. RAO was evaluated with vascular Doppler ultrasonography at 10 days after cardiac catheterisation. Results: Among 686 patients undergoing diagnostic cardiac catheterisation, RAO was detected in 36 (5.2%) patients. There was no significant difference with respect to baseline characteristics and co-morbid diseases between high dose UFH group and standard dose UFH group. RAO was significantly higher in standard dose UFH group than high dose UFH group (7.9% vs. 3.0%, p = .004). Multivariate logistic regression analysis was demonstrated that age (OR: 0.958, 95% CI: 0.924-0.993, p = .019) and standard dose heparin (OR: 2.811, 95% CI: 1.347-5.866, p = .006) were independent factor for RAO. Conclusions: High dose UFH was independently associated with a lower rate of RAO. Given that RAO nearly affects about 10% patient underwent TRA, prefer to high dose UFH may be a reasonable choice for RAO prevention.