AIM: To establish the proportion of @entity1 with @entity1459 in whom adequate anticoagulation is achieved using a standard regime of intravenous heparin. METHOD: A prospective series of 108 Emergency Department attendees over a six-month period with a clinical diagnosis of @entity1459 for whom anticoagulation with heparin was prescribed were included in the study. The standard regime was a 5000 unit bolus followed by an intravenous infusion of 1000 units per hour (1200 units if the @entity1 's weight was greater than 80 kg), with subsequent adjustments being made by reference to a nomogram. The activated partial thromboplastin time (APTT) was measured at six and 12 hours after treatment began. Two commonly used criteria for adequate heparinisation were compared: 1. APTT greater than 1.5 times control and 2. APTT in the range of 60-85 seconds. RESULTS: There were valid data for 90 @entity1 at six hours and 79 at 12 hours. Compared to the criterion for adequate anticoagulation of APTT greater than 1.5 times the control, 25% of @entity1 were subtherapeutic at six hours and 12% at 12 hours. Compared to the criterion APTT greater than 60 seconds, 53% of @entity1 were subtherapeutic at 6 hours and 47% at 12 hours. At 6 hours, 26% of @entity1 were over-anticoagulated as defined as APTT greater than 85 seconds. This had reduced to 13% by 12 hours. CONCLUSIONS: In the context of recent research suggesting that an APTT of greater than 1.5 times the control is sufficient to reduce complications in @entity1459 , our results demonstrate that a standard regime of heparinisation will achieve this goal in the majority of @entity1 within 6 hours of starting heparin therapy. However, if an APTT of 60-85 seconds is the goal, this standard regime is inadequate.

Is a standard regime for anticoagulation with heparin in XXXX adequate?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1459 :: ('MESH:D000789', 'Disease') :: ['unstable angina']
@entity1459 :: (MESH:D000789,Disease) :: ['unstable angina']
