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Low-molecular-weight heparin versus unfractionated heparin in acute ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention with drug-eluting stents

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Author(s)
Yong-Jian LiSeung-Woon RhaKang-Yin ChenKanhaiya L. PoddarZhe JinYoshiyasu MinamiLin WangQun DangGuang-Ping LiSureshkumar RamasamyJi-Young ParkChol Ung ChoiJin-Won KimEung Ju KimChang Gyu ParkHong Seog SeoDong Joo OhMyung Ho JeongYoung Keun AhnTaek Jong HongJong-Seon ParkYoung Jo KimSeung Ho HurIn Whan SeongJei Keon ChaeMyeong Chan ChoJang Ho BaeDong Hoon ChoiYang Soo JangIn Ho ChaeHyo Soo KimChong Jin KimJung Han YoonTae Hoon AhnSeung-Jea TahkWook Sung ChungKi Bae SeungSeung Jung Park
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Cardiovascular Center
Journal Title
American Heart Journal
Issued Date
2010
Volume
159
Issue
4
Abstract
Background Whether low-molecular-weight heparin (LMWH) is superior to unfractionated heparin (UFH) in acute STsegment
elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) with
drug-eluting stents (DESs) remains unclear.
Methods A total of 3,372 STEMI patients who underwent primary PCI with DESs received either LMWH (n = 1,531
patients, subcutaneous enoxaparin 1 mg/kg, bid for 3-5 days plus reduced dose of UFH [50 U/kg] during PCI) or UFH alone
(n = 1,841 patients, intravenous bolus injection of 5,000 U, followed by 24,000 U/d infusion for at least 48 hours). The
bleeding events and clinical outcomes during in-hospital and at 8 months were compared.
Results The incidences of major and minor bleeding events were similar between the 2 groups. Multivariable Cox
regression analysis showed that LMWH group had lower incidences of cardiac death (adjusted odds ratio [OR] 0.55, 95% CI
0.39-0.77, P b .001), total death (adjusted OR 0.50, 95% CI 0.37-0.68, P b .001), and total major adverse cardiac events
(adjusted OR 0.77, 95% CI 0.62-0.95, P = .017) at 8 months as compared with UFH group. Similar results were obtained
across different subgroups including different DESs, age, and sex.
Conclusions The LMWH enoxaparin combined with reduced dose of UFH (50 U/kg) administration as an adjunctive
antithrombotic therapy in STEMI patients undergoing primary PCI with DESs seems to be safe and efficacious. However,
randomized clinical trials are needed to confirm this conclusion. (Am Heart J 2010;159:684-690.e1.)
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Yong-Jian Li et al. (2010). Low-molecular-weight heparin versus unfractionated heparin in acute ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention with drug-eluting stents. American Heart Journal, 159(4), 684–690. doi: 10.1016/j.ahj.2009.12.041
Type
Article
ISSN
0002-8703
Source
https://linkinghub.elsevier.com/retrieve/pii/S0002870310000888
DOI
10.1016/j.ahj.2009.12.041
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35430
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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