Abstract:

Objective To determine the coagulation function before, during and after selective percutaneous coronary intervention (PCI) with activated coagulation (ACT) and thromboelastography (TEG), and evaluate the sensitivity and association between these two methods. Methods Thirty-six patients with stable angina undergoing selective PCI were enrolled, and unfractionated heparin (UFH) 100 U/kg was intravenously administered before PCI. ACT and TEG reaction time (TEG-R) were examined before PCI and 5 min and 30 min after UFH administration. The parameters of coagulation function (PT and APTT) and blood routine parameters (PLT, RBC and Hb) were measured before PCI and 6 h, 24 h and 72 h after PCI. Results ACT and TEG-R 5 min after UFH administration were significantly longer than those of baseline (P<0.001), while ACT significantly shortened (P<0.001) and TEG-R still maintained at a higher level (P>0.05) 30 min after UFH administration. There were significant differences between PT, APTT, RBC and Hb 6 h after PCI and those of baseline （P<0.05 or P<0.001）, while there was no significant difference between these parameters 24 h after PCI and those of baseline (P>0.05). There was no significant difference in PLT among these time points (P>0.05). Correlation analysis revealed that there was significant curvilinear correlation between ACT and TEG-R (P<0.001). Conclusion TEG-R is more sensitive than TEG-R in detection of residual UFH during PCI, which indicates that TEG may be a useful tool for monitoring of UFH therapy during PCI.

Key words: percutaneous coronary intervention, thrombelastography, activated clotting time, unfractionated heparin