Ischemic Cardiomyopathy
Conditions
Brief summary
analyzing influence of smoking on patients anti-coagulation status as assessed by ACT measurements during coronary angioplasty
Detailed description
During angioplasty, activated clotting time (ACT) measurements are recommended to attest the correct anticoagulation level and if anticoagulation levels are suboptimal after the two first boluses, additional unfractionated heparin (UFH) injections are recommended until obtention of a therapeutic ACT values (250-350s). The study hypothesis was that the procoagulant effect of the tobacco may be responsible of reduced anticoagulation levels after standardized UFH administrations and thus presenting an UFH resistance requiring increased UFH dosages to obtain a therapeutic ACT values.
Interventions
PROCEDUREcoronarography and angioplasty
selective angiography of the coronaries and angioplasty of significant culprit lesion(s)
Sponsors
Central Hospital, Nancy, France
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Inclusion criteria
* any patient older than 18 years needing a diagnostic coronarography was eligible for enrollment
Exclusion criteria
* unconscious patient * any patient presenting with one of the following characteristic known to impact either on ACT or aPTT measurements as: oral anticoagulation medication (anti-vitamin K and non-vitamin K antagonist oral anticoagulants \[NOAC\]), fondaparinux or LMWH usage, coagulopathy defined as prothrombin time \< 50 % or thrombopenia \< 50 000 G/L, declared or observed thrombophilia defined as antithrombin \< 50%, baseline aPTT values with a ratio patient/control \> 1.2 presence of lupus anticoagulant, connective tissue disease, active cancer * a person as defined by the law articles L. 1121-5, L. 1121-7 et L1121-8 of the Code de la santé publique, France (pregnant, parturient women or breastfeeding women, legally adult patient under legal protection measure \[tutelage, protection of vulnerable adults\]), * a person as defined by the law articles L. 3212-1 et L. 3213-1 of the Code de la santé publique, France (legally adult patient unable to consent, person with legal or administrative freedom restriction or person under psychiatric treatment)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ACT values after injection the first injection of a standardized unfractionated heparin bolus between non-smoking and actively smoking patients | during the intervention | comparison of ACT values after injection of two standardized UFH boluses between non-smoking and actively smoking patients (non-smoker group versus active smoker group) |
| ACT values after injection the second injection of a standardized unfractionated heparin bolus between non-smoking and actively smoking patients | immediately after the intervention | comparison of ACT values after injection of two standardized UFH boluses between non-smoking and actively smoking patients (non-smoker group versus active smoker group) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ACT values after injection of the first standardized UFH bolus in ex-smokers | during the intervention | ACT values after injection of the first standardized UFH bolus in ex-smokers requiring a coronarography followed by a PTCA |
| ACT values after injection of the second standardized UFH bolus in ex-smokers | immediately after the intervention | ACT values after injection of the second standardized UFH bolus in ex-smokers requiring a coronarography followed by a PTCA |
Countries
France
Contacts
Primary ContactEdoardo Camenzind, Professor
Backup ContactRégis Trimole, MD
Outcome results
None listed