Excess Unfractionated Heparin Dosing for STEMI and NSTEMI

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ACTION Metric

For patients with either NSTEMI or STEMI, American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend that intravenous unfractionated heparin (UFH) be dosed by weight with a bolus dose of 60 U/kg to a maximum of 4000 U and an infusion dose of 12 U/kg/h to a maximum of 1000 U/h.

As such, the quality metric used in the ACTION site report looks at the proportion of patients with excess dosing, defined as initial UFH bolus dose > 70 U/kg or infusion dose > 15 U/kg/h. Refer to site reports for STEMI (Slide 1) and NSTEMI (Slide 2).