What question did this study set out to answer?

This research aimed to evaluate the effectiveness of a heparin nomogram in achieving therapeutic anticoagulation after thrombolytic therapy for myocardial infarction.

July 11, 1994Archives of Internal Medicine

Use of a Standardized Heparin Nomogram to Achieve Therapeutic Anticoagulation After Thrombolytic Therapy in Myocardial Infarction

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Why the study?

Does a standardized heparin nomogram improve anticoagulation parameters in patients receiving thrombolytic therapy for acute myocardial infarction?

Population

Patients with acute myocardial infarction treated with thrombolytic therapy and intravenous heparin in the…

Comparison

Use of a standardized heparin nomogram to… vs Adjustment of heparin dosage according to local…

Design

Cohort

Follow-up

96 hours

Authors

GFGreg C. FlakerUniversity of North Carolina at Chapel Hill

Discussion

Member takes

Implication

Nomogram use was associated with better aPTT control; supports prospective trials before changing practice in thrombolyzed MI.

Key Points

This research aimed to evaluate the effectiveness of a heparin nomogram in achieving therapeutic anticoagulation after thrombolytic therapy for myocardial infarction.
Comparison of anticoagulation parameters between centers using and not using a heparin nomogram.
Evaluation of major hemorrhagic events and frequency of heparin interruptions in both groups.
Data collected from nine centers that followed the nomogram protocol and six that adjusted doses locally.
Subtherapeutic activated partial thromboplastin time values found in 46% of patients at 48 hours.
Centers with the nomogram had 38.1% interruptions in heparin therapy compared to 68.7% without it (P<.001).
No significant difference in rates of major spontaneous hemorrhage, reinfarction, and reocclusion between groups.

Structured PICO

Does a standardized heparin nomogram improve anticoagulation parameters in patients receiving thrombolytic therapy for acute myocardial infarction?

Population

Patients with acute myocardial infarction treated with thrombolytic therapy (frontloaded rtPA, APSAC, or both) and intravenous heparin (5000 U bolus, followed by 1000 U/h) in the TIMI 4 Study.

Intervention

Use of a standardized heparin nomogram to maintain therapeutic activated partial thromboplastin time (aPTT) at 1.5 to 2 times the control value.

Comparator

Adjustment of heparin dosage according to local practice without the use of the recommended nomogram.

Outcome

Anticoagulation parameters (frequency of subtherapeutic aPTT values), major hemorrhagic events, and frequency of heparin interruption.surrogate

The use of a standardized heparin nomogram improves the achievement of therapeutic anticoagulation and reduces heparin interruptions in patients receiving thrombolytic therapy for myocardial infarction.

Cite This Study

Greg C. Flaker (1994) studied this question.

synapsesocial.com/papers/6a702c7975498292b7098e15 https://doi.org/10.1001/archinte.1994.00420130084011

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Use of a Standardized Heparin Nomogram to Achieve Therapeutic Anticoagulation After Thrombolytic Therapy in Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Use of a Standardized Heparin Nomogram to Achieve Therapeutic Anticoagulation After Thrombolytic Therapy in Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider