Safety and efficacy of immediate heparin reversal with protamine after complex percutaneous coronary intervention.

Autor: Choi JH; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Chun KJ; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea. ptca82@gmail.com., Jung SM; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Lee SY; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Chon MK; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Lee SH; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Hwang KW; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Kim JS; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Park YH; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea., Kim JH; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam, 626-770, South Korea.
Jazyk: angličtina
Zdroj: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2022 May 10; Vol. 22 (1), pp. 207. Date of Electronic Publication: 2022 May 10.
DOI: 10.1186/s12872-022-02650-5
Abstrakt: Background: Compared to simple percutaneous coronary intervention (PCI), complex PCI is associated with higher bleeding and thrombotic risk. No previous study has evaluated the use of protamine after PCI with contemporary technologies. This study aimed to evaluate the safety and efficacy of manual compression with and without protamine after transfemoral complex PCI.
Methods: We retrospectively analyzed 160 patients (protamine group, n = 92; non-protamine group, n = 68) who underwent complex PCI via the femoral artery. The primary outcome was a composite of in-hospital death, myocardial infarction, stent thrombosis, stroke/systemic embolism, bleeding requiring blood transfusion, and vascular access complications.
Results: The primary outcome was significantly lower in the protamine group than in the non-protamine group (4.3% vs. 17.6%; p = 0.006). This was driven mainly by the lower incidences of hematoma in the protamine group (3.3% vs. 13.2%, p = 0.020). Furthermore, the protamine group had a significantly shorter hospital stay than the non-protamine group (4.8 ± 3.7 days vs. 8.4 ± 8.3 days, p = 0.001). While > 90% of the patients had acute coronary syndrome, there were no incidences of myocardial infarction or stent thrombosis in either group.
Conclusions: Among patients who underwent complex PCI via transfemoral access, immediate protamine administration was associated with a significantly lower rate of vascular access complications, especially hematoma, and shorter hospital stay than no protamine administration.
(© 2022. The Author(s).)
Databáze: MEDLINE
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