Body weight rather than unfractionated heparin dose predicts periprocedural bleeding during elective PCI

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Optimal anticoagulation for elective percutaneous coronary intervention (PCI) is debated, especially in East Asian populations prone to bleeding.
• Lower body weight and bleeding susceptibility are key concerns in this demographic.

Purpose of the Study:

• To investigate the relationship between body weight, unfractionated heparin (UFH) dose, and periprocedural bleeding during elective PCI.
• To assess bleeding risk factors in Japanese patients undergoing PCI.

Main Methods:

• Retrospective single-center study of 348 Japanese patients undergoing elective PCI.
• Comparison of fixed-dose UFH (10,000 U) versus weight-adjusted UFH (100 U/kg).
• Stratification of fixed-dose group by weight-adjusted UFH exposure (≥150 vs. <150 U/kg).

Main Results:

• Lower bleeding event rates observed in the low-dose UFH group (24%) compared to the high-dose group (40%, P < 0.001).
• Multivariable analysis revealed lower body weight as an independent predictor of increased bleeding risk (OR 0.948, P = 0.027).
• Unfractionated heparin dose was not independently associated with bleeding risk.

Conclusions:

• Lower body weight appears more strongly associated with periprocedural bleeding than UFH dose in elective PCI.
• Clinicians should consider careful bleeding risk assessment for patients with low body weight undergoing PCI.