Key result
Median heparin dose during PCI increased ~33% from 2016 to 2024.
Why the study?
The study was motivated by a subjective observation that the required dose of unfractionated heparin during PCI procedures has increased over time.
Has the required unfractionated heparin dose administered during PCI increased over time between 2016 and 2024?
Observational (n=900)
No
Has the required unfractionated heparin dose administered during PCI increased over time between 2016 and 2024?
Absolute Event Rate: 12000% vs 9000%
p-value: p=<0.001
There has been a significant, unexplained increase in the required dose of unfractionated heparin to achieve target ACT during PCI procedures from 2016 to 2024.
Heparin doses during PCI rose over 8 years; hypothesis-generating for procedural evolution, prospective outcome studies needed before practice implications.
Unfractionated heparin (UFH) is routinely used in percutaneous coronary intervention (PCI). The aim of this study was to determine whether the required dose of heparin used during PCI procedures has increased over time, which was our subjective observation. This retrospective study analysed the required heparin dosage in 100 consecutive patients undergoing isolated PCI for each year between 2016 and 2024, starting from 1 January of each year. The primary analysis compared the total heparin dose administered (a) unadjusted and (b) adjusted for weight and procedure duration, between annual populations. A secondary analysis compared heparin dosage in patients with at least one activated clotting time (ACT) value >250 seconds, the target ACT level at our centre. The median total heparin dose rose from 9,000 units (U) in 2016 (interquartile range [IQR] 7,000-11,000 U), to 12,000 U (IQR 10,000-15,000 U) in 2024 (p<0.001). The median weight- and time-adjusted total heparin dose in 2016 was 1.95 (IQR 1.44-2.77) U/kg/min compared with 2.93 (IQR 2.1-3.8) U/kg/min in 2024 (p<0.001). In the secondary analysis (in those who achieved a target ACT >250 seconds), the median dose was 1.81 (IQR 1.21-2.24) U/kg/min in 2016 versus 2.59 (IQR 2.03-3.22) U/kg/min in 2024 (p<0.001). In conclusion, there has been a significant and unexplained increase in the total administered heparin dose for PCI cases in this centre between 2016 and 2024.
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Nick P. Curzen (2026) conducted an observational in Undergoing isolated PCI (n=900). Time period (2024) vs. Time period (2016) was evaluated on Total heparin dose administered (unadjusted) (p=<0.001). The median total unfractionated heparin dose required during PCI significantly increased from 9,000 U in 2016 to 12,000 U in 2024 (p<0.001).
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