Journal of Invasive Cardiology (JIC)Comparison of Fixed Dose Versus Weight-Adjusted Heparin on the Prevention of Radial Artery Occlusion After Diagnostic Transradial Catheterization

A randomized trial of 1,494 patients evaluated whether weight-adjusted heparin doses affect radial artery occlusion (RAO) rates in diagnostic transradial catheterization. The study compared outcomes across four quartiles of weight-adjusted heparin dosing, all using a standard fixed dose of 5000 IU. The findings challenge current weight-based dosing recommendations and suggest potential benefits of standardized protocols.

Key Points:

• RAO rates showed no significant differences across weight-adjusted heparin quartiles: 2.1% (<58.14 IU/kg), 2.6% (58.14-65.79 IU/kg), 2.8% (65.79-74.63 IU/kg), and 3.0% (>74.63 IU/kg); P=.86
• Comparison of extreme dosages (<50 IU/kg vs >80 IU/kg) revealed similar RAO rates (1.9% vs 2.5%; P=.71), with no major bleeding events reported
• The fixed 5000 IU heparin dose proved effective across all weight groups, potentially simplifying anticoagulation protocols in diagnostic procedures
• Short-duration pneumatic compression was used uniformly for hemostasis, likely contributing to consistently low RAO rates
• Study limitations include lack of ultrasound guidance during access and exclusion of interventional procedures from analysis

HCN Medical Memo
Standard fixed-dose heparin (5000 IU) provides effective RAO prevention across weight ranges, potentially streamlining catheterization laboratory protocols without compromising safety.

Vascular Medicine Summaries