- Class I:
- Patients undergoing percutaneous or surgical revascularization.
- Class IIa:
- Intravenously in patients undergoing reperfusion therapy with alteplase. Comment: The
recommended regimen is 70 U/kg as a bolus at initiation of alteplase infusion, then an
initial maintenance dose of ~15 µg/kg per hour, adjusted to maintain aPTT at 1.5 to 2.0
times control (50 to 75 seconds) for 48 hours. Continuation of heparin infusion beyond 48
hours should be restricted to patients at high risk for systemic or venous
thromboembolism.
- (new text)
- Subcutaneously (7500 U twice daily) (intravenous heparin is an acceptable alternative)
in all patients not treated with thrombolytic therapy who do not have a contraindication
to heparin. In patients who are at high risk for systemic emboli (large or anterior MI,
atrial fibrillation [AF], previous embolus, or known LV thrombus), intravenous heparin is
preferred.
- Intravenously in patients treated with nonselective thrombolytic agents (streptokinase,
anistreplase, urokinase) who are at high risk for systemic emboli (large or anterior MI,
AF, previous embolus, or known LV thrombus).
- Class IIb:
- Patients treated with nonselective thrombolytic agents, not at high risk, subcutaneous
heparin, 7500 U to 12 500 U twice a day until completely ambulatory.
- Class III:
- Routine intravenous heparin within 6 hours to patients receiving a nonselective
fibrinolytic agent (streptokinase, anistreplase, urokinase) who are not at high risk for
systemic embolism.
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- Class IIa:
- Intravenously in patients undergoing reperfusion therapy with
alteplase. Comment: The recommended regimen is 60 U/kg as a bolus at initiation of
alteplase infusion, then an initial maintenance dose of ~12 U/kg per hour (with a maximum
of 4000 U bolus and 1000 U/h infusion for patients weighing >70 kg), adjusted to
maintain aPTT at 1.5 to 2.0 times control (50 to 70 seconds) for 48 hours. Continuation of
heparin infusion beyond 48 hours should be considered in patients at high risk for
systemic or venous thromboembolism.
- Intravenous unfractionated heparin (UFH) or low-molecular-weight
heparin (LMWH) subcutaneously for patients with non-ST-elevation MI.
- Subcutaneous UFH (eg, 7500 U BID) or LMWH (eg, enoxaparin 1 mg/kg
BID) in all patients not treated with thrombolytic therapy who do not have a
contraindication to heparin. In patients who are at high risk for systemic emboli (large
or anterior MI, AF, previous embolus, or known LV thrombus), intravenous heparin is
preferred.
- Intravenously in patients treated with nonselective thrombolytic
agents (streptokinase, anistreplase, urokinase) who are at high risk for systemic emboli
(large or anterior MI, AF, previous embolus, or known LV thrombus).
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