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Patients undergoing cardiac catheterization will be randomized to 3 groups: no anticoagulant, low dose anticoagulant and high dose anticoagulant.
Patients undergoing diagnostic cardiac catheterization via the trans-radial approach will be randomly allocated (1:1:1) to receive either low-dose UFH (25 IU/Kg -maximal dose 3,000 IU), high-dose UFH 50 IU/kg -maximal dose 5,000 IU) or N/S 0.9%. After 30 minutes, patients will undergo a gradual wrist band release. Hematoma and radial artery occlusion will be assessed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low dose heparin | Active Comparator | heparin (25 IU/Kg -maximal dose 3,000 IU) |
|
| High dose heparin | Active Comparator | heparin 50 IU/kg -maximal dose 5,000 IU |
|
| Placebo | Placebo Comparator | Normal saline 0.9%. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Heparin | Drug | two doses of heparin |
| |
| Measure | Description | Time Frame |
|---|---|---|
| radial artery occlusion | by ultrasound | 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Hematoma> 5 cm | Hematoma at access site | one hour post procedure |
| access site bleeding | any bleeding | 1 hour |
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Inclusion Criteria:
Exclusion Criteria:
abnormal ulno-palmar circulation; Prior radial artery thrombosis; Prior surgery close to the access site; Emergent cardiac catheterization; History of HIT or allergy to heparin; Patients requiring anticoagulation
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shahar Lavi, MD | Contact | 519-6633611 | Shahar.lavi@lhsc.on.ca |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hamilton Health Sciences | Recruiting | Hamilton | Ontario | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41985829 | Derived | Lavi S, Shadpour S, Allen E, Ogunsakin RE, Mehta SR. Design and rational of the the PRACTICAL-HERO trial: A randomized trial of higher and lower doses of heparin vs placebo for elective diagnostic coronary angiography. Am Heart J. 2026 Aug;298:107441. doi: 10.1016/j.ahj.2026.107441. Epub 2026 Apr 13. |
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| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D006493 | Heparin |
| ID | Term |
|---|---|
| D006025 | Glycosaminoglycans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
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| Placebos |
| Drug |
placebo |
|
| non access site bleeding | bleeding not related to access site, such as gastrointestinal | 1 day |
| access site complications | pseudoaneurysm, arteriovenous fistula | 1 day |
| wrist band duration | How long wrist band was on | 3 hours |
| time to discharge | when patient was able to leave the post procedure care area | 1 day |
| London Health Sciences Centre | Recruiting | London | Ontario | N6A5A5 | Canada |
|