When do you start anticoagulation after PCI?

Oral anticoagulation plus P2Y12 antiplatelet combination is recommended for the first 6-12 months (potentially switching P2Y12 to aspirin for months 6-12 if PCI for stable ischemic heart disease), followed by anticoagulation monotherapy after 12 months.

When do you stop heparin after cardiac catheterization?

When UFH is given without a GP IIb/IIIa receptor antagonist, the bolus dose should be increased to 70 to 100 U/kg followed by continuous infusion to achieve and maintain therapeutic ACT between 250 and 350 seconds. UFH should be discontinued immediately after catheterization is complete.

How long should you use anticoagulation after a stent?

A substantial number of patients who undergo PCI with stent implantation after an acute myocardial infarction develop left ventricular thrombus and are at increased risk of embolism (6% to 12% annually), so anticoagulation therapy is recommended for at least 3 months for these patients.

Why do patients need anticoagulation after coronary stenting?

Anticoagulant therapy has been acknowledged to improve the prognosis of patients after stenting by reducing the risk of coronary and systemic thromboembolism. Firstly, the benefit–risk ratio of post-PCI parenteral anticoagulation to prevent stent thrombosis locally in the coronary artery is still unclear.

Are there alternatives to heparin in the setting of PCI?

It is relatively rare in the setting of PCI but can be seen with repeated exposures to UFH. 19 The development of thrombocytopenia in patients undergoing PCI is an ominous sign and is associated with increased mortality. 20 Because of the limitations of heparin ( Table ), several other alternatives have been studied in the setting of PCI.

When to stop heparin infusion after cardiac catheterisation?

Apply pressure above insertion site with gauze to achieve haemostasis. Haemostasis should occur within 5-10 minuets. If patient has a heparin infusion, stop infusion. Reinforce pressure bandage. Notify physician (catheterisation fellow- office hours: pager 5719, after hours: pager 5718). Assess if this is a new arrhythmia for the patient.

When to use oral anticoagulant in PCI patients?

For PCI with stable ischemic heart disease or acute coronary syndrome, use of oral anticoagulant plus a P2Y 12 inhibitor for no more than 12 months is recommended, followed by oral anticoagulation alone. For patients with cerebrovascular disease without carotid stenting, oral anticoagulation monotherapy is recommended.

When to take antiplatelet monotherapy for PCI patients?

Patients using antiplatelet therapy for primary cardiovascular disease prevention or >12 months from the most recent PCI or acute coronary syndrome can be treated with anticoagulation monotherapy. For patients taking DOAC medications who require PCI, most DOACs can be held for no more than 36-48 hours prior to the procedure.