Opposition: Unfractionated heparin should no longer be used in the catheterization laboratory
Moo Hyun Kim,1 Young Seok Lee,2 Michael S. Lee3
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IntroductionThe goal of anticoagulation during percutaneous coronary intervention (PCI) is the primary and secondary prevention of thrombotic and significant bleeding events that increase cardiovascular morbidity and mortality. Unfractionated heparin is the most commonly-used anticoagulant, but low-molecular weight heparin, and more recently bivalirudin are becoming increasingly popular in cardiac catheterization laboratories(1).
Moo Hyun Kim, Director, Regional Clinical Trial Center, Professor; Dept. of Cardiology, Dong-A University Hospital, 3-1, Dongdaeshin-Dong, Seo-Gu, Busan, Korea 602-715
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2. Levine GN, Bate ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 2011;124: e574–e651. CrossRef
3. White HD, Kleiman NS, Mahaffey KW, et al. Efficacy and safety of enoxaparin compared with unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention in the Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial. Am Heart J 2006; 152: 1042–50. PubMed CrossRef
4. Fifth Organization to Assess Strategies in Acute Ischemic Syndromes investigators. Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med 2006; 354: 1464–76. CrossRef
5. Lincoff AM, Bittl JA, Harrington RA, et al, for the REPLACE-2 investigators. Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial. JAMA 2003; 289: 853–63. PubMed CrossRef
8. Muramatsu T. Current technical and clinical features of the antegrade and retrograde approaches to percutaneous transluminal coronary intervention for chronic total occlusion-2013 version. Syllabus of TOPIC meeting 2013. p179.
9. Sharman S, Patel S, Behl A, et al. Extensive Fatal Intracoronary Thrombosis During Percutaneous Coronary Intervention With Bivalirudin. Am J Ther 2013 Jul 25 [Epub ahead of print].
11. Dangas GD, Mehran R, Nikolsky E, et al. Effect of switching anti-thrombotic agents for primary angioplasty in acute myocardial infarction. The HORIZONS-SWITCH analysis. J Am Coll Cardiol 2011;57:2309–2316. PubMed CrossRef
12. Koutouzis M, Lagerqvist B, James S, et al. Unfractionated heparin administration in patients treated with bivalirudin during primary percutaneous coronary intervention is associated lower mortality and target lesion thrombosis: a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Heart 2011;97 (18):1484–8. PubMed CrossRef
14. Shahzad A, Cooper RM, Stables RH. Anthithrombotic therapy in PCI: Why not heprin? Eurointervention 2013;22:423–6. CrossRef
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