Abstract
Results In 100 patients (mean age 67.1, 65% male), no significant differences were observed in ACT values obtained from the guiding catheter and arterial sheath (mean difference (MD) −18.3 s; standard deviation (SD) 96 s; P=0.067). Contrarily, ACT values obtained from the intravenous line were significantly lower as compared to values obtained from the guiding catheter (MD 25.7 s; SD 75.5; P=0.003) and arterial sheath (MD 39 s; SD 102.8; P < 0.001). Furthermore, ACT measurements from the arterial sheath showed a statistically significant proportional bias when compared to the other sampling sites (sheath vs. catheter, r = 0.761, P=0.001; sheath vs. IVL, r = 1.013, P < 0.001). Conclusions The present study shows statistical significance and possibly clinically relevant variations between ACT measurements from different sample sites. Bias in ACT measurements may be minimized by using uniform protocols for ACT measurement during cardiac catheterization.
Highlights
Unfractionated heparin (UFH) is the mainstay of antithrombotic therapy for the prevention of thrombus formation in coronary angiography (CAG) and percutaneous coronary intervention (PCI)
Since the mid-1970s, UFH has been used to prevent thrombus formation in patients during bypass surgery and soon became common practice for patients undergoing PCI for the reduction of ischemic complications [1,2,3,4,5,6]. e inconsistency of dose and effect of UFH led to the development of new direct thrombin inhibitors such as bivalirudin to provide anticoagulation, for instance, during PCI in patients with acute myocardial infarction [7, 8]
No studies aiming at standardisation of activated clotting time (ACT) measurements at the catheterization laboratory have been currently conducted. erefore, the aim of the present study is to investigate the influence of the sampling site on the variability of ACT values at the end of coronary angiography or PCI
Summary
Unfractionated heparin (UFH) is the mainstay of antithrombotic therapy for the prevention of thrombus formation in coronary angiography (CAG) and percutaneous coronary intervention (PCI). Journal of Interventional Cardiology important as it may influence the incidence of ischemic and bleeding complications during these complex procedures. Standardized protocols or clinical guidelines for the use of ACT measurement in cardiac catheterization are lacking. At this time, it is unknown if the site of blood sampling influences ACT values. Erefore, the aim of the present study is to investigate the influence of the sampling site on the variability of ACT values at the end of coronary angiography or PCI No studies aiming at standardisation of ACT measurements at the catheterization laboratory have been currently conducted. erefore, the aim of the present study is to investigate the influence of the sampling site on the variability of ACT values at the end of coronary angiography or PCI
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