Clinical safety and cost of heparin titration using bedside activated clotting time.

OBJECTIVE

To evaluate the clinical safety of heparin titration and the procedural cost of anticoagulation measurement using bedside low-range activated clotting time.

DESIGN

Quasi-experimental study using data gathered through retrospective record review.

SETTING

Coronary care, medical intensive care and telemetry units of a community hospital.

SUBJECTS

Sample of 102 patients undergoing elective percutaneous transluminal coronary angioplasty.

INTERVENTION

Intravenous heparin therapy was titrated using low-range activated clotting time in 51 percutaneous transluminal coronary angioplasty patients. Data from this group were compared to a matched sample of 51 angioplasty patients whose intravenous heparin therapy was titrated using activated partial thromboplastin time.

RESULTS

No differences in procedural, early or late complications were found between the groups. The cost of managing heparin therapy with low-range activated clotting time was less than with activated partial thromboplastin time.

CONCLUSION

These results suggest that titrating heparin therapy based on bedside low-range activated clotting time for the angioplasty patients in this sample was as safe as with activated partial thromboplastin time. Use of bedside low-range activated clotting time saved money for the hospital.