The use of a bolus of intravenous heparin while initiating heparin therapy in anticoagulation following @entity63 or XXXX does not lead to increased morbidity or mortality.

@entity1 @entity64 @entity63 @entity1229 @entity3459 @entity3290 @entity4066
Intravenous heparin therapy is often used in @entity1 presenting with @entity63 ( @entity63 ) or @entity64 as either bridging therapy for anticoagulation with @entity1229 , or as primary therapy in suspected intracranial @entity4066 , crescendo TIAs, or suspected hypercoagulable @entity3290 . We examined the use of a bolus of intravenous heparin at the start of anticoagulation during hospital admission for @entity1 with @entity63 or @entity64 . A subgroup analysis of a prospective, single-blinded, randomized clinical trial was undertaken to examine the effect of providing an intravenous bolus of heparin prior to continuous intravenous maintenance heparin therapy. Pre-treatment clinical factors were comparable between subgroups. Thirty-three @entity1 received a bolus at initiation of therapy and 173 @entity1 did not. @entity1 receiving a bolus had a significantly higher first activated partial thromboplastin time at 6 h after initiation of therapy than @entity1 without bolus (87.6 +/- 36.3 versus 61.0 +/- 8.1 s). @entity1 receiving bolus achieved an initial activated partial thromboplastin time greater than the minimum threshold for the therapeutic range of anticoagulation (> 60 s) sooner than @entity1 without bolus (9.6 +/- 7.3 versus 14.5 +/- 10.8 h), but did not have a significantly greater chance of achieving therapeutic range (60-90 s). The fraction of time during which anticoagulation was therapeutic was similar between @entity1 receiving bolus or not. There was no significant difference between the number of @entity3459 results, total dosage of intravenous heparin received, complications due to anticoagulation, nor the times required for discontinuation of heparin and discharge from hospital between subgroups. The use of an intravenous heparin bolus during initiation of anticoagulation for @entity63 or @entity64 does not appear to be associated with greater risks and can achieve a minimum therapeutic range faster than therapy without heparin bolus.
