Abstract
Background: Intravenous unfractionated heparin (UFH) is commonly used for therapeutic anticoagulation in patients with acute pulmonary embolism (PE), which requires close therapeutic monitoring. Recent observational studies suggest low rates of therapeutic activated partial thromboplastin time (aPTT) values.
Aims and objectives: To assess the effectiveness of UFH therapy for acute PE in a multicentre cohort.
Methods: Adult patients with acute PE at four hospitals in Calgary, Canada from 2012-2017 were included. Outcomes assessed were the proportion of patients achieving at least one therapeutic aPTT (1.5-2.5 times control) and the therapeutic range (TTR) within 24 hours. We stratified the analyses by patients who received a UFH bolus.
Results: 632 (30.2%) patients admitted for acute PE received UFH. 553 (87.5%) patients were high-risk by sPESI. 416 (65.8%) patients received a UFH bolus prior to the infusion versus 216 (34.1%) who received infusion-only. 541 (85.6%) were admitted to a regular ward, and 91 (14.4%) to the ICU. 408 (64.6%) patients had an aPTT in the therapeutic range by 24 hours and 528 (83.5%) had at least one aPTT above the lower limit of the therapeutic range by 24 hours. Mean percent TTR at 24 hours was 40.4% (SD 32.5) and mean percent time above the lower limit of the therapeutic threshold was 78.5% (SD 32.5). Mean percent time above the lower limit of the therapeutic threshold at 24 hours with a UFH bolus given was 80.4% (SD 30.6), and without was 75.2% (SD 35.5).
Conclusion: UFH was commonly used for acute PE in this cohort. Contrary to prior studies, over 80% of patients achieved either a therapeutic or supratherapeutic aPTT levels within 24h.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA2596.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021