MedPath

Effect of Smoking on Activated Clotting Time Values During Coronarography and Angioplasty

Conditions
Ischemic Cardiomyopathy
Interventions
Procedure: coronarography and angioplasty
Registration Number
NCT04897997
Lead Sponsor
Central Hospital, Nancy, France
Brief Summary

analyzing influence of smoking on patients anti-coagulation status as assessed by ACT measurements during coronary angioplasty

Detailed Description

During angioplasty, activated clotting time (ACT) measurements are recommended to attest the correct anticoagulation level and if anticoagulation levels are suboptimal after the two first boluses, additional unfractionated heparin (UFH) injections are recommended until obtention of a therapeutic ACT values (250-350s).

The study hypothesis was that the procoagulant effect of the tobacco may be responsible of reduced anticoagulation levels after standardized UFH administrations and thus presenting an UFH resistance requiring increased UFH dosages to obtain a therapeutic ACT values.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
120
Inclusion Criteria
  • any patient older than 18 years needing a diagnostic coronarography was eligible for enrollment
Exclusion Criteria
  • unconscious patient
  • any patient presenting with one of the following characteristic known to impact either on ACT or aPTT measurements as: oral anticoagulation medication (anti-vitamin K and non-vitamin K antagonist oral anticoagulants [NOAC]), fondaparinux or LMWH usage, coagulopathy defined as prothrombin time < 50 % or thrombopenia < 50 000 G/L, declared or observed thrombophilia defined as antithrombin < 50%, baseline aPTT values with a ratio patient/control > 1.2 presence of lupus anticoagulant, connective tissue disease, active cancer
  • a person as defined by the law articles L. 1121-5, L. 1121-7 et L1121-8 of the Code de la santé publique, France (pregnant, parturient women or breastfeeding women, legally adult patient under legal protection measure [tutelage, protection of vulnerable adults]),
  • a person as defined by the law articles L. 3212-1 et L. 3213-1 of the Code de la santé publique, France (legally adult patient unable to consent, person with legal or administrative freedom restriction or person under psychiatric treatment)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
acute coronary syndromecoronarography and angioplastypatients with the coronary indication of ACS
stablecoronarography and angioplastypatients with the coronary indication of stable or silent ischemia
non smokerscoronarography and angioplastynever having smoked patients
smokerscoronarography and angioplastyactively smoking patients
Primary Outcome Measures
NameTimeMethod
ACT values after injection the second injection of a standardized unfractionated heparin bolus between non-smoking and actively smoking patientsimmediately after the intervention

comparison of ACT values after injection of two standardized UFH boluses between non-smoking and actively smoking patients (non-smoker group versus active smoker group)

ACT values after injection the first injection of a standardized unfractionated heparin bolus between non-smoking and actively smoking patientsduring the intervention

comparison of ACT values after injection of two standardized UFH boluses between non-smoking and actively smoking patients (non-smoker group versus active smoker group)

Secondary Outcome Measures
NameTimeMethod
ACT values after injection of the second standardized UFH bolus in ex-smokersimmediately after the intervention

ACT values after injection of the second standardized UFH bolus in ex-smokers requiring a coronarography followed by a PTCA

ACT values after injection of the first standardized UFH bolus in ex-smokersduring the intervention

ACT values after injection of the first standardized UFH bolus in ex-smokers requiring a coronarography followed by a PTCA

Trial Locations

Locations (1)

University Hospital Nancy Brabois

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Vandœuvre-lès-Nancy, France

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