The Living Guidelines: Ancillary Therapy for Patients Undergoing PCI for STEMI Suggest Revisions to the CLASS I Guidelines

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Class I Guidelines

 * 1) For patients undergoing PCI after having received an anticoagulant regimen, the following dosing recommendations should be followed:
 * a. For prior treatment with UFH, administer additional boluses of UFH as needed to support the procedure, taking into account whether GP IIb/IIIa receptor antagonists have been administered. (Class I Level of Evidence: C) Bivalirudin may also be used in patients treated previously with UFH. (Class I Level of Evidence: C)


 * b. For prior treatment with enoxaparin, if the last subcutaneous dose was administered at least 8 to 12 hours earlier, an IV dose of 0.3 mg/kg of enoxaparin should be given; if the last subcutaneous dose was administered within the prior 8 hours, no additional enoxaparin should be given. (Class I Level of Evidence: B)


 * c. For prior treatment with fondaparinux, administer additional intravenous treatment with an anticoagulant possessing anti-IIa activity, taking into account whether GP IIb/IIIa receptor antagonists have been administered. (Class I Level of Evidence: C)