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Relation of Activated Clotting Times During Percutaneous Coronary Intervention to Outcomes.

Publication ,  Journal Article
Rajpurohit, N; Gulati, R; Lennon, RJ; Singh, M; Rihal, CS; Santrach, PJ; Donato, LJ; Karon, BS; Del-Carpio, F; Tak, T; Motiei, A; Lopes, RD ...
Published in: Am J Cardiol
March 1, 2016

Monitoring anticoagulation using the activated clotting time (ACT) in patients treated with heparin and undergoing percutaneous coronary intervention (PCI) is one of the most frequently used tests in invasive cardiology. However, despite its widespread use and guideline endorsement, uncertainty remains regarding the association of ACT with outcomes in contemporary practice. We reviewed all PCI procedures performed at the Mayo Clinic (Rochester, Minnesota) from October 2001 to December 2012 and evaluated the association between the ACT before device activation and in-hospital and 1-year outcomes. ACT values were grouped into tertiles for descriptive purposes and analyzed as a continuous variable for assessment of outcomes. We used logistic and Cox proportional hazards regression models to estimate the association of ACT and outcomes. Of the 12,055 patients who underwent PCI with an ACT value before device activation, 3,977 (33.0%) had an ACT <227, 4,046 (33.6%) had an ACT 227 to 285, and 4,032 (33.4%) had an ACT >285. Baseline and procedural characteristics were similar across ACT tertiles. In unadjusted analysis, higher ACT values were associated with death (p <0.001), bleeding (p = 0.024), procedural complication (p <0.001), and higher 1-year events (cardiac death, p <0.001; cardiac death/myocardial infarction, p = 0.022). After multivariable adjustment for baseline and procedural characteristics, ACT was not independently associated with in-hospital or 1-year ischemic, thrombotic, or bleeding outcomes. In conclusion, ACT values before device activation are not independently associated with clinically important outcomes in contemporary PCI practice.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

March 1, 2016

Volume

117

Issue

5

Start / End Page

703 / 708

Location

United States

Related Subject Headings

  • Whole Blood Coagulation Time
  • Thrombosis
  • Retrospective Studies
  • Prognosis
  • Postoperative Complications
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Monitoring, Intraoperative
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Rajpurohit, N., Gulati, R., Lennon, R. J., Singh, M., Rihal, C. S., Santrach, P. J., … Gharacholou, S. M. (2016). Relation of Activated Clotting Times During Percutaneous Coronary Intervention to Outcomes. Am J Cardiol, 117(5), 703–708. https://doi.org/10.1016/j.amjcard.2015.12.003
Rajpurohit, Naveen, Rajiv Gulati, Ryan J. Lennon, Mandeep Singh, Charanjit S. Rihal, Paula J. Santrach, Leslie J. Donato, et al. “Relation of Activated Clotting Times During Percutaneous Coronary Intervention to Outcomes.Am J Cardiol 117, no. 5 (March 1, 2016): 703–8. https://doi.org/10.1016/j.amjcard.2015.12.003.
Rajpurohit N, Gulati R, Lennon RJ, Singh M, Rihal CS, Santrach PJ, et al. Relation of Activated Clotting Times During Percutaneous Coronary Intervention to Outcomes. Am J Cardiol. 2016 Mar 1;117(5):703–8.
Rajpurohit, Naveen, et al. “Relation of Activated Clotting Times During Percutaneous Coronary Intervention to Outcomes.Am J Cardiol, vol. 117, no. 5, Mar. 2016, pp. 703–08. Pubmed, doi:10.1016/j.amjcard.2015.12.003.
Rajpurohit N, Gulati R, Lennon RJ, Singh M, Rihal CS, Santrach PJ, Donato LJ, Karon BS, Del-Carpio F, Tak T, Motiei A, Lopes RD, Gharacholou SM. Relation of Activated Clotting Times During Percutaneous Coronary Intervention to Outcomes. Am J Cardiol. 2016 Mar 1;117(5):703–708.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

March 1, 2016

Volume

117

Issue

5

Start / End Page

703 / 708

Location

United States

Related Subject Headings

  • Whole Blood Coagulation Time
  • Thrombosis
  • Retrospective Studies
  • Prognosis
  • Postoperative Complications
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Monitoring, Intraoperative
  • Male