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Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study

The aim of this study is to assess the practice of heparin administration in real-life situations. This study was conducted at the coronary care unit (CCU) in one of the busiest hospitals in Kuwait; with special attention to the rate of heparin resistance, potential factor that may predict resistanc...

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Autores principales: Alsayegh, Faisal, Al-Rasheed, Mona, Al-Muhaini, Ali, Al-Humoud, Ekhlas, Al-Ostaz, Mona, Mousa, Shaker A
Formato: Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728894/
https://www.ncbi.nlm.nih.gov/pubmed/19426243
http://dx.doi.org/10.1111/j.1755-5922.2009.00076.x
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author Alsayegh, Faisal
Al-Rasheed, Mona
Al-Muhaini, Ali
Al-Humoud, Ekhlas
Al-Ostaz, Mona
Mousa, Shaker A
author_facet Alsayegh, Faisal
Al-Rasheed, Mona
Al-Muhaini, Ali
Al-Humoud, Ekhlas
Al-Ostaz, Mona
Mousa, Shaker A
author_sort Alsayegh, Faisal
collection PubMed
description The aim of this study is to assess the practice of heparin administration in real-life situations. This study was conducted at the coronary care unit (CCU) in one of the busiest hospitals in Kuwait; with special attention to the rate of heparin resistance, potential factor that may predict resistance or responsiveness and heparin related complications. A prospective observational study was conducted in Farwania hospital over a 4-month period; this study included 146 patients admitted to the CCU. Patients were treated with UFH according to a standard normogram. Several variables were collected and analyzed, including demographic data, initial diagnosis, activated partial thromboplastin time (APTT) on admission and at 6, 24, and 48 h after UFH administration, and any complications that occurred. A significant number of patients had subtherapeutic APTT at 6, 24, and 48 h (41.1%, 42.3%, and 46.7%, respectively). There were four factors that predicted heparin resistance, including race, gender, admitting diagnosis (unstable angina vs. acute myocardial infarction), and an APTT ratio of less than one on admission. There was no significant difference in the rate of development of complications among different groups. Heparin resistance is a common phenomenon especially in the first period of heparin therapy. Special attention should be given to some groups like females, patients admitted with unstable angina, and those with APTT below the normal range. Evidence based protocols for Heparin administration and monitoring must be adopted to prevent the risk of under or over anticoagulation.
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spelling pubmed-27288942009-08-27 Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study Alsayegh, Faisal Al-Rasheed, Mona Al-Muhaini, Ali Al-Humoud, Ekhlas Al-Ostaz, Mona Mousa, Shaker A Cardiovasc Ther Research The aim of this study is to assess the practice of heparin administration in real-life situations. This study was conducted at the coronary care unit (CCU) in one of the busiest hospitals in Kuwait; with special attention to the rate of heparin resistance, potential factor that may predict resistance or responsiveness and heparin related complications. A prospective observational study was conducted in Farwania hospital over a 4-month period; this study included 146 patients admitted to the CCU. Patients were treated with UFH according to a standard normogram. Several variables were collected and analyzed, including demographic data, initial diagnosis, activated partial thromboplastin time (APTT) on admission and at 6, 24, and 48 h after UFH administration, and any complications that occurred. A significant number of patients had subtherapeutic APTT at 6, 24, and 48 h (41.1%, 42.3%, and 46.7%, respectively). There were four factors that predicted heparin resistance, including race, gender, admitting diagnosis (unstable angina vs. acute myocardial infarction), and an APTT ratio of less than one on admission. There was no significant difference in the rate of development of complications among different groups. Heparin resistance is a common phenomenon especially in the first period of heparin therapy. Special attention should be given to some groups like females, patients admitted with unstable angina, and those with APTT below the normal range. Evidence based protocols for Heparin administration and monitoring must be adopted to prevent the risk of under or over anticoagulation. Blackwell Publishing Ltd 2009 /pmc/articles/PMC2728894/ /pubmed/19426243 http://dx.doi.org/10.1111/j.1755-5922.2009.00076.x Text en © 2009 Blackwell Publishing Ltd http://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.
spellingShingle Research
Alsayegh, Faisal
Al-Rasheed, Mona
Al-Muhaini, Ali
Al-Humoud, Ekhlas
Al-Ostaz, Mona
Mousa, Shaker A
Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study
title Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study
title_full Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study
title_fullStr Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study
title_full_unstemmed Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study
title_short Heparin Anticoagulation Responsiveness in a Coronary Care Unit: A Prospective Observational Study
title_sort heparin anticoagulation responsiveness in a coronary care unit: a prospective observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728894/
https://www.ncbi.nlm.nih.gov/pubmed/19426243
http://dx.doi.org/10.1111/j.1755-5922.2009.00076.x
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