ISAR-REACT 3A: a study of reduced dose of unfractionated heparin in biomarker negative patients undergoing percutaneous coronary intervention
Why the study?
Does a reduced dose of 100 U/kg unfractionated heparin improve net clinical outcomes compared to 140 U/kg in biomarker-negative patients undergoing PCI?
Population
2,505 biomarker negative patients undergoing percutaneous coronary intervention after clopidogrel…
Comparison
Unfractionated heparin single bolus of 100 U/kg vs Historical control of 140 U/kg unfractionated…
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
May support 100 U/kg UFH dosing in biomarker-negative PCI; leaves open confirmation in randomized trials.
Structured PICO
Does a reduced dose of 100 U/kg unfractionated heparin improve net clinical outcomes compared to 140 U/kg in biomarker-negative patients undergoing PCI?
P
Population
2,505 biomarker negative patients undergoing percutaneous coronary intervention (PCI) after clopidogrel pre-treatment
I
Intervention
Unfractionated heparin (UFH) single bolus of 100 U/kg
C
Comparator
Historical control of 140 U/kg unfractionated heparin (n=2,281) and historical bivalirudin arm (n=2,289) from the ISAR-REACT 3 trial
O
Outcome
Net clinical outcome (composite of death, myocardial infarction, urgent target-vessel revascularization within 30 days, or in-hospital REPLACE 2 defined major bleeding)composite
A reduced dose of 100 U/kg unfractionated heparin provides a net clinical benefit compared to 140 U/kg in biomarker-negative patients undergoing PCI, primarily driven by a reduction in bleeding.
Cite This Study
Schulz et al. (2010) studied this question.