American Heart Journal
Volume 156, Issue 2 , Pages 209-215 , August 2008

Unfractionated heparin dosing and risk of major bleeding in non–ST-segment elevation acute coronary syndromes

  • Chiara Melloni, MD, MHS

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • Corresponding Author InformationReprint requests: Chiara Melloni, MD, MHS, 2400 Pratt St., Duke Clinical Research Institute, Durham, NC 27705.
    • ,
  • Karen P. Alexander, MD

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • ,
  • Anita Y. Chen, MS

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • ,
  • L. Kristin Newby, MD, MHS

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • ,
  • Matthew T. Roe, MD, MHS

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • ,
  • Nancy M. Allen LaPointe, PharmD

      Affiliations

    • Division of Clinical Pharmacology, Duke University Medical Center, Durham, NC
    • ,
  • Charles V. Pollack Jr, MD, MA

      Affiliations

    • Emergency Department, Pennsylvania Hospital, Philadelphia, PA
    • ,
  • W. Brian Gibler, MD

      Affiliations

    • Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH
    • ,
  • E. Magnus Ohman, MD

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • ,
  • Eric D. Peterson, MD, MPH

      Affiliations

    • Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    • ,
  • for the CRUSADE Investigators

Received 13 December 2007 ,Accepted 26 March 2008.

References 

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  3. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. The PURSUIT Trial Investigators. Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy. N Engl J Med. 1998;339:436–443
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  11. Platelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization. The EPILOG Investigators. N Engl J Med. 1997;336:1689–1697
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  17. Hoekstra JW, Pollack CV, Roe MT, et al. Improving the care of patients with non–ST-elevation acute coronary syndromes in the emergency department: the CRUSADE initiative. Acad Emerg Med. 2002;9:1146–1155
  18. LaPointe NMA, Chen AY, Alexander KP, et al. Enoxaparin dosing and associated risk of in-hospital bleeding and death in patients with non ST-segment elevation acute coronary syndromes. Arch Intern Med. 2007;167:1539–1544
  19. Liang K. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13
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  22. Lee MS, Wali AU, Menon V, et al. The determinants of activated partial thromboplastin time, relation of activated partial thromboplastin time to clinical outcomes, and optimal dosing regimens for heparin treated patients with acute coronary syndromes: a review of GUSTO-IIb. J Thromb Thrombolysis. 2002;14:91–101
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  26. Teich JM, Merchia PR, Schmiz JL, et al. Effects of computerized physician order entry on prescribing practices. Arch Intern Med. 2000;160:2741–2747
  27. Alexander KP, Chen AY, Roe MT, et al. Excess dosing of antiplatelet and antithrombin agents in the treatment of non–ST-segment elevation acute coronary syndromes. JAMA. 2005;294:3108–3116

PII: S0002-8703(08)00233-0

doi: 10.1016/j.ahj.2008.03.023

American Heart Journal
Volume 156, Issue 2 , Pages 209-215 , August 2008

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