Why the study?
Despite protamine sulfate being a known heparin reversal agent, its use during interventional procedures remains heterogeneous, accompanied by risks of hypersensitivity reactions.
What is the existing evidence and experience regarding the use of protamine sulfate in percutaneous coronary and structural interventional procedures?
What is the existing evidence and experience regarding the use of protamine sulfate in percutaneous coronary and structural interventional procedures?
This review summarizes the contemporary evidence and experience with protamine sulfate as a heparin reversal agent in the cardiac catheterization laboratory, highlighting its utility and potential risks such as anaphylaxis.
Heterogeneity in protamine use for heparin reversal during PCI signals need for standardized protocols; leaves open optimal dosing and safety outcomes in prospective studies.
Access to the arterial circulation and full anticoagulation carries a risk of serious bleeding during and after percutaneous coronary intervention. Important sources of bleeding include the arterial access site and coronary artery perforation. Prompt and effective management of hemorrhagic complications is an essential interventional skill. Protamine sulfate is well-known as a heparin reversal agent. Despite this, there is heterogeneity in the use of protamine during interventional procedures. While protamine is generally well-tolerated, it is associated with a risk of hypersensitivity reaction, including anaphylaxis, among others. The purpose of this review is to summarize the existing evidence about and experience with the use of protamine sulfate in the setting of percutaneous coronary and structural interventional procedures.
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Danek et al. (2023) studied this question.
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