Measuring Activated Clotting Time during Cardiac Catheterization and PCI: The Effect of the Sampling Site

Area of Science:

• Cardiology
• Medical Device Technology

Background:

• Accurate activated clotting time (ACT) monitoring is vital for anticoagulation management during cardiac catheterization procedures.
• Variations in ACT measurements from different arterial and venous sites may impact clinical decision-making.

Purpose of the Study:

• To evaluate the agreement and identify potential bias in ACT measurements obtained from the guiding catheter, arterial sheath, and intravenous line.
• To determine if ACT readings differ significantly based on the blood sampling site during cardiac catheterization.

Main Methods:

• A prospective study involving 100 patients undergoing cardiac catheterization.
• Simultaneous ACT measurements were taken from the guiding catheter, arterial sheath, and an intravenous line.
• Statistical analysis included mean difference, standard deviation, P-values, and proportional bias assessment.

Main Results:

• No significant difference was found between ACT values from the guiding catheter and arterial sheath (P=0.067).
• ACT values from the intravenous line were significantly lower than those from the guiding catheter (P=0.003) and arterial sheath (P<0.001).
• Significant proportional bias was observed in ACT measurements from the arterial sheath compared to other sites (P<0.001).

Conclusions:

• Statistically significant and potentially clinically relevant variations exist in ACT measurements based on the sampling site.
• Implementing uniform protocols for ACT measurement during cardiac catheterization can help minimize measurement bias and improve reliability.