New heparin dosing regimen for diabetics undergoing percutaneous coronary intervention

It has been previously demonstrated that diabetics are less sensitive to heparin compared to non-diabetics. We hypothesized that an initial heparin dose of 80 IU/kg administered to diabetics rather than 70 IU/kg might yield a more optimal initial ACT of 300 to 350 seconds when glycoprotein IIb/IIIa receptor antagonists are not used. We prospectively studied 130 elective PCI patients without diabetes treated with 70 IU/kg of unfractionated heparin and 81 elective PCI patients with diabetes treated with 80 IU/kg, and compared the initially achieved ACT. The mean heparin dose given per kg was greater (by intention) in diabetics versus non-diabetics. Despite that, there was no significant difference in the initially achieved ACT in diabetics and non-diabetics.