Related Experiment Video

Updated: Jul 13, 2026

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

Impact of different Asian ethnic groups on correlation between heparin dose, activated clotting time and

Chi-Hang Lee, Esther Tan, Hwee-Bee Wong

    International Journal of Cardiology
    |August 21, 2007
    PubMed

    The current recommended weight-adjusted dosing regimen of unfractionated heparin and target activated clotting time (ACT) in percutaneous coronary intervention (PCI) is based on limited data from the western population, and the applicability in the various Asian ethnic groups remains unknown. This is a retrospective study in an Asian university teaching hospital. Among the 1287 patients who have undergone PCI, Chinese constituted 70.4% (n=906), Malay 15.5% (n=199) and Indian 14.1% (n=182). Overall, the mean total heparin dose was 6224+/-1548 U, mean weight-adjusted heparin dose was 95+/-30 U/kg, and mean ACT was 325+/-95 s. There was no significant difference in the 3 ethnic groups. Both the incidences of in-hospital ischemic complications (Chinese 2.4%, Malay 3.5%, Indian 2.2%, p=0.641) as well as in-hospital bleeding complications (Chinese 4.5%, Malay 3.5%, Indian 6.0%, p=0.490) were similar in the 3 ethnic groups. When the patients were divided based on ACT into 3 groups:<250, 250-350 and>350 seconds, the incidence of ischemic complication (2.5%, 2.5%, 2.7%) was similar (p=819), while that of bleeding complications (4.1%, 3.5%, 6.8%) showed a strong trend (p=0.057) of increased risk in patients with ACT>350 s. In conclusion, the recommended weight-adjusted heparin-dosing regimen in PCI derived from the western population is equally applicable to the Asian patients. ACT does not correlate with in-hospital ischemic complications, but increased bleeding complications were observed with ACT>350 s.

    Related Concept Videos

    Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

    Anticoagulant Drugs: Low-Molecular-Weight Heparins

    Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
    Venous Thrombosis III: Interprofessional Care01:29

    Venous Thrombosis III: Interprofessional Care

    Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
    Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

    Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

    Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
    Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
    Drug Toxicity: Risk factors01:24

    Drug Toxicity: Risk factors

    Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
    Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

    Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu

    Genetic variations significantly influence drug response through pharmacokinetics, receptor interactions, and biologic milieu modifications. Pharmacokinetic alterations impact drug metabolism and clearance, affecting efficacy and toxicity. Variants in drug-metabolizing enzymes, such as CYP2C9 and CYP2C19, alter drug activation and elimination. For example, CYP2C9 loss-of-function variants require lower warfarin doses to prevent excessive bleeding, while CYP2C19 variants reduce clopidogrel...
    Drug toxicity: Idiosyncratic Reactions01:16

    Drug toxicity: Idiosyncratic Reactions

    Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...