{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:11:15Z","timestamp":1780312275755,"version":"3.54.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unfractionated heparin (UFH) remains the standard anticoagulant during percutaneous coronary intervention (PCI), with guidelines recommending a target activated clotting time (ACT) of \u2265250\u2009s. However, despite receiving a standardized bolus dose, many patients fail to achieve this target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of standard UFH bolus dose in achieving the target ACT and to identify patient\u2010related factors associated with suboptimal anticoagulant response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center, prospective observational study included 171 patients undergoing PCI between October 2024 and April 2025. All patients received a 100\u2009IU\/kg intravenous UFH bolus immediately before PCI. ACT was measured 5\u2009min after administration, and additional 50\u2009IU\/kg boluses were given as needed to achieve an ACT\u2009\u2265\u2009250\u2009s. The primary endpoint was the proportion of patients achieving this target after the initial bolus. The secondary endpoint was the identification of factors associated with suboptimal anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 171 patients (mean age 68 years; 26.3% women), the target ACT was achieved in 35.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200961), while 64.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009110) did not. Active smoking was independently associated with failure to reach the target ACT (adjusted OR, 6.06; 95% CI, 1.41 to 43.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032), although the confidence interval was wide. Despite similar weight\u2010adjusted UFH dosing and timing to ACT measurement, smokers had significantly lower ACT values (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and required higher cumulative UFH dose during PCI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). Propensity\u2010score matching confirmed this association (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this prospective cohort, nearly two\u2010thirds of patients did not achieve the recommended ACT target after a standard 100\u2009IU\/kg UFH bolus during PCI. Active smoking was independently associated with failure to reach therapeutic ACT levels, although this association should be interpreted cautiously. These findings underscore the variability of UFH response and reinforce the importance of ACT monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70610","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:14:59Z","timestamp":1775448899000},"page":"2293-2303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variability in ACT Response to Standard UFH Bolus During PCI: A Prospective Study on Determinants of Subtherapeutic Anticoagulation"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5894-0585","authenticated-orcid":false,"given":"Manh Cuong","family":"Vu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Nouvel H\u00f4pital Civil Strasbourg University Hospital Strasbourg 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H\u00f4pital Civil Strasbourg University Hospital Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anis","family":"Elidrissi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nouvel H\u00f4pital Civil Strasbourg University Hospital Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8126-7281","authenticated-orcid":false,"given":"Marion","family":"Kibler","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nouvel H\u00f4pital Civil Strasbourg University Hospital Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Jesel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nouvel H\u00f4pital Civil Strasbourg University Hospital Strasbourg France"},{"name":"UR 3074 Translational Cardiovascular Medicine CRBS University of Strasbourg 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Medicine CRBS University of Strasbourg Strasbourg France"},{"name":"Hanoi Medical University Hanoi 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