image dons

je fais un don

Impact of anticoagulation regimens on sheath management and bleeding in patients undergoing elective percutaneous coronary intervention in the STEEPLE trial.

Colloquium "Rythme et conduction" (23 avril 2024)
Programme et inscription, c'est ici !

Bourses ACTION 2024 - Prix de Recherche JP Collet et Y Grosgogeat - PHRA 2024
M2, thèse de sciences, mobilité et soins infirmiers : deadline 15 mars - PHRA : deadline 30 mars

La Grande Journée du Coeur - Rendez-vous dans un cadre exceptionnel : l'Eglise Saint-Louis de la Pitié-Salpêtrière le jeudi 27 juin 2024
A vos agendas !

Impact of anticoagulation regimens on sheath management and bleeding in patients undergoing elective percutaneous coronary intervention in the STEEPLE trial.

Publié dans Catheterization and Cardiovascular Interventions, le 15 février 2009.

En savoir plus en consultant le site.

Auteurs : Gallo R, Steinhubl SR, White HD, Montalescot G; STEEPLE Investigators.

Abstract

OBJECTIVE:

To evaluate the impact of sheath management on bleeding rates.

BACKGROUND:

The procedural characteristics and anticoagulant regimen determine the frequency of postoperative bleeding complications following percutaneous coronary intervention (PCI).

METHODS:

This subanalysis of the SafeTy and Efficacy of Enoxaparin in PCI patients, an internationaL randomized Evaluation (STEEPLE) trial evaluated the relative impact of enoxaparin or unfractionated heparin (UFH) on the rate of non-coronary artery bypass graft-related major and minor bleeding, according to sheath management procedures in 3,528 patients undergoing elective PCI with a femoral approach.

RESULTS:

Sheaths were removed at a median time of 54 min with enoxaparin 0.5 mg/kg, compared with 3 hr 14 min with enoxaparin 0.75 mg/kg and 2 hr 24 min with UFH. Early sheath removal (within 30 min from the end of PCI) was associated with reduced bleeding in patients receiving 0.5 or 0.75 mg/kg enoxaparin compared with UFH (enoxaparin 0.5 mg/kg: 4.9% vs. 10.8%; P < 0.001; enoxaparin 0.75 mg/kg: 5.0% vs. 10.8%; P < 0.001). Compared with UFH, major and minor bleeding was halved when enoxaparin (0.5 mg/kg and 0.75 mg/kg) was used in combination with a closure device (4.4% and 5.3% vs. 10.5% with UFH) or smaller (<7 Fr) sheath sizes (4.9% and 6.0% vs. 9.3%).

CONCLUSION:

This analysis shows that early sheath removal can be performed safely following elective PCI in patients receiving enoxaparin. Enoxaparin use was associated with less major and minor bleeding compared with UFH, when either a closure device or a smaller sheath size was used.

Autres actualités

+

01/10/2023


Rationale and design of the ARAMIS trial: Anakinra versus pl...

Arch Cardiovasc Dis. 2023 Oct;116(10):460-466
+

01/09/2023


Comparison of three echo-guidance techniques in percutaneous...

Arch Cardiovasc Dis. 2023 Sep 29:S1875-2136(23)00171-7