Abstract
Background/Introduction
Current guidelines do not recommend heparins crossover in percutaneous coronary intervention (PCI) between unfractionated heparin (UFH) and low molecular weight heparin (LMWH), which is only based on the post-randomization crossovers analysis of SYNERGY trial. However, in real-world practice, heparins crossover is common.
Purpose
To evaluate bleeding complications in patients who underwent PCI using periprocedural crossover of heparin therapy.
Methods
From January 2015 to December 2019, all consecutive patients who underwent PCI in our hospital were retrospectively enrolled in this analysis. The primary outcome was a hemoglobin drop ≥3g/dl within 72 hours after the procedure.
Results
A total of 5,001 patients, including 4,487 (89.72%) with heparins crossover. As shown in figure 1, after a 1:4 ratio of propensity score matching of age, gender, prior medical history, vital signs, body mass index, puncture site, coronary lesion number, stent number, baseline hemoglobin and platelet counts, 539 with crossover and 165 without were matched. There was no difference of the incident of bleeding (1.67% vs. 0.61%, P=0.562) and thrombocytopenia (1.86% vs. 1.82%, P=0.562) between the two groups. In multivariate adjusted logistic regression models, there was no significant association with heparins crossover and bleeding (odds ratio: 0.36; 95% CI, 0.05–2.85) or thrombocytopenia (odds ratio: 0.95; 95% CI, 0.26–3.53).
Conclusion(s)
In this real-world retrospective analysis of a single center, the periprocedural heparins crossover was not associated with increased bleeding or thrombocytopenia risk.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Youth clinical research project of Peking University First Hospital
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