Direct Oral Anticoagulants Affect Activated Clotting Time During and Bleeding Events After Percutaneous Coronary Intervention

Inappropriately high activated clotting time (ACT) during percutaneous coronary intervention (PCI) is associated with an increased risk of bleeding events. However, whether the prescription of direct oral anticoagulants (DOACs) affects ACT kinetics during heparin use and adverse clinical events in p...

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Bibliographic Details
Published in:The American journal of cardiology 2023-10, Vol.204, p.1-8
Main Authors: Shibahashi, Eiji, Abe, Takuro, Kamishima, Kazuho, Ebihara, Suguru, Moriyama, Tetsu, Shimazaki, Kensuke, Saito, Katsumi, Uchigata, Yasuko, Jujo, Kentaro
Format: Article
Language:English
Subjects:
activated clotting time
Angina pectoris
Angioplasty
Anticoagulants
Bleeding
bleeding event
Cardiovascular disease
Clotting
direct oral anticoagulant
Diuretics
Drug dosages
Enzymes
Heart attacks
Hemoglobin
Heparin
Ischemia
Observational studies
percutaneous coronary intervention
Thrombocytopenia
Thromboembolism
Thrombosis
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Summary:Inappropriately high activated clotting time (ACT) during percutaneous coronary intervention (PCI) is associated with an increased risk of bleeding events. However, whether the prescription of direct oral anticoagulants (DOACs) affects ACT kinetics during heparin use and adverse clinical events in patients who underwent PCI remains unclear. We aimed to evaluate the relations between ACT changes during and adverse clinical events after PCI in patients who were prescribed DOAC. This observational study included 246 patients who underwent PCI at the 2 cardiovascular centers who were not receiving warfarin and whose ACT was recorded immediately before and 30 minutes after injection of unfractionated heparin. Patients were divided into 2 groups according to DOAC prescription at the time of the index PCI: DOAC users (n = 31) and nonusers (n = 215). Any bleeding and systemic thromboembolic events were investigated until 30 days after PCI. The average age of this population was 70.5 years, and 66.3% were male. Average ACT was significantly higher in DOAC users than nonusers both before and 30 minutes after unfractionated heparin induction (157.2 ± 30.1 vs 131.8 ± 25.1 seconds, p 
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2023.07.092