Clinical Benefit of Low Molecular Weight Heparin for ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Glycoprotein IIb/IIIa Inhibitor
- Affiliated Author(s)
- 허승호
- Alternative Author(s)
- Hur, Seung Ho
- Journal Title
- Journal of Korean Medical Science
- ISSN
- 1011-8934
- Issued Date
- 2010
- Keyword
- Myocardial Infarction; Heparin; Blood Platelets; Prognosis
- Abstract
- The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated
heparin (UFH) during percutaneous coronary intervention (PCI) with or without
glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor
has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST
elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute
Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group
with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059).
These groups were further subdivided according to the use of LMWH with low dose
UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or
myocardial infarction during the 30 days after the registration. The primary end point
occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa
inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor
(odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006).
Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in
LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For
patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is
more beneficial than UFH.
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