Putting heparin into perspective: Its history and the evolution of its use during Percutaneous Coronary Interventions

Heparin has been the companion of the interventional cardiologist since the first PCI was performed nearly 25 years ago. Most data available today would support the contention that heparin's ability to prevent intravascular thrombosis and its sequelae is dose-dependent. However, the ability to predict and to quantify the anticoagulant effect of heparin within the range of doses used during PCI is limited, and the risk of bleeding increases as the dose of heparin is increased. Newer developments such as the use of low molecular weight derivatives of heparin and the use of direct antagonists of thrombin may be useful in improving the safety and efficacy of anticoagulation during interventional procedures.