Evaluation of the Interference of Antithrombotic Agents With Laboratory Monitoring of Heparin Therapy

Oral anticoagulants are increasingly prescribed and the are not discontinued for invasive cardiac procedures . Additional parenteral anticoagulation is necessary for these procedures (FA ablation and invasive coronary explorations). The unfractionated heparin doses are adapted on a monitoring test heparin, activated clotting time (ACT) with the aim of obtaining and maintaining an ACT \> 300-400 sec. This goal is the same whether the patient is on oral anticoagulant treatment or not, and regardless of the initial level of anticoagulation. The effects of oral anticoagulants on routine coagulation tests (PT, APTT, TT) are well documented, but few data have been published on the effects of heparin monitoring tests, particularly on the ACT. The aim of this stuy is to redefine the target values of ACT and unfractionated heparin doses to administer to optimize the efficacy / safety of invasive procedures in cardiology.