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In Reply: In response to Dr Pedrini and colleagues, we did not design our study to evaluate the important question of the duration of antithrombin therapy. Our protocol suggested a minimum duration of treatment with unfractionated or low-molecular-weight heparin of 48 hours, but treatment duration could be shortened for those undergoing early percutaneous intervention, with heparin discontinuation permitted 12 hours after intervention. Maximal duration for study-provided medications was limited to 120 hours by protocol. Although not based on data from randomized controlled trials, this strategy is consistent with American College of Cardiology/American Heart Association guideline recommendations.¹

With respect to the points raised by Drs Kanna and Sharma, at 6 to 12 hours, 12 to 24 hours, and 24 to 48 hours, the proportions of individuals with subtherapeutic aPTT values were 39%, 43%, and 47%, respectively; with therapeutic aPTT values, 30%, 35%, and 35%; and with supratherapeutic aPTT values, 31%, 22%, . . . [Full Text of this Article]

Michael A. Blazing, MD
blazi001@mc.duke.edu
Duke Clinical Research Institute
Durham, NC

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