Premium
Effects of local heparin administration on coronary thrombin activity during percutaneous transluminal coronary angioplasty
Author(s) -
Laskey Warren K.,
Zawacki Kevin,
Lim Richard,
Herzog William
Publication year - 1999
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(199909)48:1<84::aid-ccd17>3.0.co;2-o
Subject(s) - medicine , heparin , activated clotting time , coronary sinus , cardiology , anesthesia , antithrombin , anticoagulant
Simultaneously obtained blood samples from the coronary sinus and systemic arterial circulation were analyzed for antithrombin III (ATIII) activity and fibrinopeptide A (FpA) concentration in nine patients undergoing elective PTCA in order to determine the effects of locally delivered heparin. Samples were obtained at the following designated times: prior to the administration of systemic heparin (period I); 5 min following a loading dose of systemic heparin (period II); 5 min following the final balloon inflation but prior to local delivery (period III); and 5 min following the administration of 4,000 units of unfractionated heparin using a local delivery catheter system (period IV). We found consistent increases in both systemic arterial ( P = 0.006) and coronary sinus ( P = 0.0002) ATIII activity with systemic heparinization designed to prolong the activated clotting time to 300 sec. However, local delivery of heparin further increased coronary sinus ATIII activity ( P = 0.003, period III vs. period IV). FpA concentration decreased in both systemic arterial ( P < 0.0001) and coronary sinus ( P < 0.0001) samples following systemic heparinization. Moreover, local delivery of heparin further decreased coronary sinus FpA concentration ( P = 0.04). Thus, on a background of intense anticoagulation during PTCA, the local delivery of 4,000 units of unfractionated heparin confers incremental antithrombotic activity. Cathet. Cardiovasc. Intervent. 48:84–88, 1999. © 1999 Wiley‐Liss, Inc.