A randomized trial of antithrombin concentrate for treatment of heparin resistance
Key result
Antithrombin concentrate increases immediate therapeutic ACT achievement to 96% vs heparin in heparin resistance.
- P=0.001
- n=85
Why the study?
Heparin resistance is an important clinical problem traditionally treated with additional heparin or fresh frozen plasma, but the effectiveness of antithrombin concentrate for this condition was uncertain.
Does antithrombin concentrate improve the achievement of a therapeutic activated clotting time in patients with heparin resistance requiring cardiopulmonary bypass?
Comparison
1000 U antithrombin concentrate vs additional heparin
Design
Randomized clinical trial
Authors
Discussion
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Member takes
Implication
AT concentrate achieves therapeutic ACT more reliably and rapidly than additional heparin in heparin-resistant CPB patients; supports targeted AT replacement in this setting.
Study Design
Type
RCT (n=85)
Structured PICO
Does antithrombin concentrate improve the achievement of a therapeutic activated clotting time in patients with heparin resistance requiring cardiopulmonary bypass?
P
Population
85 patients requiring cardiopulmonary bypass with heparin resistance.
I
Intervention
Antithrombin (AT) concentrate 1000 U
C
Comparator
Additional heparin
O
Outcome
Immediately obtaining a therapeutic activated clotting timesurrogate
Main Result
Absolute Event Rate: 96% vs 68%
p-value: p=0.001
Antithrombin concentrate is more effective and faster than additional heparin for achieving adequate anticoagulation in patients with heparin resistance during cardiopulmonary bypass.
Cite This Study
Williams et al. (2000) conducted an RCT in Heparin resistance (n=85). Antithrombin (AT) concentrate vs. Additional heparin was evaluated on Immediately obtaining a therapeutic activated clotting time (p=0.001). Antithrombin concentrate was more effective than additional heparin for immediately obtaining a therapeutic activated clotting time in heparin-resistant patients (96% vs 68%, p=0.001).