Key result
A standard protocol for anticoagulation after intracoronary stent insertion recommends heparin for up to 96 hours after starting warfarin to manage thrombosis risk and INR interference.
The text outlines a protocol rationale for overlapping heparin and warfarin for up to 96 hours to prevent stent thrombosis after intracoronary stent insertion.
May support 96-hour heparin overlap after stenting with warfarin initiation; leaves open randomized confirmation of thrombosis prevention.
Stents rarely thrombose in the first 24 hours after implantation; secondly, heparin has some influence on the extrinsic pathway. Additionally, if too much heparin is present it interferes with the INR, and the half life of prothrombin suggests that the patient should be anticoagulated with heparin for up to 96 hours after starting warfarin. This is the evidence on which our standard protocol is based.
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Brack et al. (1994) studied Intracoronary stent insertion. Heparin and warfarin was evaluated. A standard protocol for anticoagulation after intracoronary stent insertion recommends heparin for up to 96 hours after starting warfarin to manage thrombosis risk and INR interference.
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