Protamine does not increase risk of stroke in patients with elective carotid stenting

Jennifer S. McDonald, David F. Kallmes, Giuseppe Lanzino, Harry J. Cloft

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


BACKGROUND AND PURPOSE - : Reversal of anticoagulation with protamine might predispose to a higher risk of stroke in patients with carotid stenting. We evaluated a national, multihospital patient database to examine the risk of stroke in patients with carotid stenting receiving protamine compared with those who did not. METHODS - : The Premier Perspective database was used to identify patients who were electively hospitalized for carotid stenting from 2006 through 2011. The incidence of in-hospital mortality and morbidity was compared between patients who did and did not receive protamine after propensity score adjustment via 1:1 matching to reduce selection bias. RESULTS - : Of 6664 patients with carotid stenting treated at 193 hospitals, 556 (8%) received protamine on the day of the procedure. After matching by propensity score, patients who received protamine had a similar likelihood of stroke or transient ischemic attack (P=0.77), in-hospital mortality (P=0.12), discharge to long-term care (P=0.15), and access site complications (P=0.90) as compared with patients who did not receive protamine. CONCLUSIONS - : Protamine administration is not associated with additional risk of adverse events after carotid stenting.

Original languageEnglish (US)
Pages (from-to)2028-2030
Number of pages3
Issue number7
StatePublished - Jul 2013


  • carotid stenosis
  • carotid stenting
  • coagulation
  • outcomes research
  • protamine

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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