Author + information
Background: Unfractionated heparin (UFH) is used to reduce the risk of radial artery occlusion (RAO) after transradial cardiac catheterization. But, the utility and dosing strategy of UFH have been scrutinized. We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy of UFH in reducing RAO in patients undergoing cardiac catheterization using radial access.
Methods: MEDLINE, EMBASE and the Cochrane Register were searched from 1948 to July 2016. RCTs comparing the use of UFH in reducing RAO in transradial coronary angiograms were included. Data were combined using random effects models.
Results: Of 220 citations, 6 RCTs (n=2464) were included. Only 1 study (n=400) compared UFH versus no UFH. It showed no difference in RAO reduction (odds ratio [OR] 1.08 [95% confidence interval [CI] 0.51 – 2.29], p=0.85). When comparing higher-dose UFH (5000 IU) versus lower-dose UFH (2000-3000 IU) (n=2064), we found a reduction in RAO, but heterogeneity was observed (OR 0.37 [95% CI 0.14 −0.99], p=0.05; I2=84%). When comparing bleeding events, no significant difference was noted (OR 1.75 [95% CI 0.93-3.29], p=0.08, I2 0%).
Conclusions: To date, there are limited data supporting the use of UFH for RAO prevention in transradial cardiac catheterization. However, higher compared to lower-dose UFH may reduce the risk of RAO. Given the heterogeneous data, an adequately powered randomized trial is required to determine the role of UFH for diagnostic coronary angiograms using the radial approach.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Developments in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1194-155
- 2017 American College of Cardiology Foundation