{"id":410,"date":"2010-12-15T15:35:05","date_gmt":"2010-12-15T14:35:05","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=410"},"modified":"2015-11-12T14:17:24","modified_gmt":"2015-11-12T13:17:24","slug":"no-benefit-seen-from-low-dose-heparin-in-pci-2","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2010\/12\/15\/no-benefit-seen-from-low-dose-heparin-in-pci-2\/","title":{"rendered":"No benefit seen from low dose heparin in PCI"},"content":{"rendered":"

In the OASIS-5 trial (Organzation to Assess Strategies in Acute Ischaemic Syndromes), fondaparinux was found to be non-inferior to enoxaparin for the primary outcome, but was noted to halve major bleeding, leading to a significant mortality reduction. However, a small but significant increase in catheter-related thromboses was also seen, therefore the FUTURA\/OASIS-8 trial was set up to evaluate the safety of two-dose regimens of adjunctive intravenous unfractionated heparin during PCI in high-risk patients with non-ST segment elevation acute coronary syndromes initially treated with fondaparinux.<\/p>\n

2026 patients were enrolled from February 2009 to March 2010. Patients received either low dose unfractionated heparin (50U\/kg) or standard-dose unfractionated heparin (85U\/kg), adjusted by blinded activated clotting time (ACT). The main outcome measure was a composite of major bleeding, minor bleeding, or major vascular access-site complications up to 48hrs after PCI.<\/p>\n

The primary outcome measure occurred in 4.7% of the low-dose group vs 5.8% in the standard-dose group (p=\u200a.27). Minor bleeding rates were noted to be different (0.7% vs 1.7%; p=\u200a.04), however no difference in major bleeding rates was seen. Death, myocardial infarction, or target vessel revascularisation occurred in 4.5% in the low-dose group, compared to 2.9% in the standard dose group (p=\u200a.06). Catheter thrombus rates were low (0.5% vs 0.1%, p=\u200a.15), and therefore no statistically significant difference was seen.<\/p>\n

Conclusions<\/h4>\n

In this trial, no significant benefit was seen from using low-dose unfractionated heparin as part of a two-dose regiment during high-risk PCI for acute coronary syndromes.<\/p>\n

\u25b6\u00a0FUTURA\/OASIS-8 trial group, 2010<\/strong>. Low-dose versus standard-dose unfractionated heparin for percutaneous coronary intervention in acute coronary syndromes treated with fondaparinux. The FUTURA\/OASIS-8 randomized trial.\u00a0JAMA<\/em> 2010. doi:10.1001\/jama.2010.1320<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

In the OASIS-5 trial (Organzation to Assess Strategies in Acute Ischaemic Syndromes), fondaparinux was found to be non-inferior to enoxaparin for the primary outcome, but was noted to halve major bleeding, leading to a significant mortality reduction. However, a small but significant increase in catheter-related thromboses was also seen, therefore the FUTURA\/OASIS-8 trial was set […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":141,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[280],"tags":[],"class_list":["post-410","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology"],"yoast_head":"\nNo benefit seen from low dose heparin in PCI - Heart<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/heart\/2010\/12\/15\/no-benefit-seen-from-low-dose-heparin-in-pci-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"No benefit seen from low dose heparin in PCI - Heart\" \/>\n<meta property=\"og:description\" content=\"In the OASIS-5 trial (Organzation to Assess Strategies in Acute Ischaemic Syndromes), fondaparinux was found to be non-inferior to enoxaparin for the primary outcome, but was noted to halve major bleeding, leading to a significant mortality reduction. 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