Tolerability of percutaneous coronary interventions in patients receiving nadroparin calcium for unstable angina or non-Q-wave myocardial infarction: the Angiofrax study.
BACKGROUND
Nadroparin, a low-molecular-weight heparin (LMWH), is an alternative to unfractionated heparin for the acute management of patients with non-ST elevation acute coronary syndrome (ACS): unstable angina or non-Q-wave myocardial infarction. However, unfractionated heparin can be substituted for LMWH in patients requiring percutaneous coronary interventions (PCIs) for the duration of the procedure. The tolerability of this anti-thrombotic regimen (i.e. unfractionated heparin for the duration of PCIs, preceded and followed by subcutaneous injection of nadroparin) is not yet documented.


METHODS
This open-label 6-day study was carried out in 302 patients to test the tolerability of this anti-thrombotic regimen in patients requiring PCIs. The primary end-point of the study was the incidence of major haemorrhage over the whole study duration (6 days). The secondary end-point was the need for transfusion and vascular repair after PCI.


RESULTS
The incidence of major haemorrhage in patients undergoing coronary angiography (CA) without or with PCIs was 1.4% and 1.3%, respectively, and the incidence of minor haemorrhage was 10.7% and 23.5%, respectively. These results are consistent with published data.


CONCLUSIONS
These results suggest that CA and PCIs can be performed safely in patients being treated for unstable angina or non-Q-wave myocardial infarction receiving nadroparin pre- and post-coronary procedure and/or intervention, substituted by unfractionated heparin for the duration of the intervention.
University Hospital Jean-Minjoz, Besançon, France. jean-pierre.bassand@ufc-chu.univ-fcomte.fr
Jean-Pierre
JP
Bassand
Christian
C
Berthe
Armando
A
Bethencourt
Leonardo
L
Bolognese
Jaroslaw
J
Wójcik
D000368:Aged; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D017762:Nadroparin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D017762:Nadroparin