[Enoxaparin vs. non-fractionated heparin in primary angioplasty of acute myocardial infarction].
OBJECTIVE
The objective of this study is to compare the effectiveness of intravenous enoxaparin (ENX) and Non-fractionated Heparin (NFH) in primary angioplasty (PA) of acute myocardial infarction (PA-AMI).


METHODS
A prospective, observational study.


METHODS
A total of 191 patients admitted at the hospital with the diagnosis of Acute Myocardial Infarction (AMI) and treated with primary angioplasty were included. ENX was used in 91 patients (47.6%) and NFH in 100 patients (52.4%). Choice of treatment was based on the operator's opinion. Patients with cardiogenic shock were excluded. The first group received an intravenous bolus of ENX (0.75-1 mg/Kg) and the second one NFH (70-100 u/Kg), depending on whether it was associated with abciximab or not. In-hospital follow-up was performed, evaluating mortality and bleeding complications of both treatments.


RESULTS
In-hospital mortality was 1.1% for the ENX group and 3.3% for NFH one. No significant differences were found in the number of bleeding complications with ENX (4.4%) and NFH (9.0%). There was one subacute thrombosis of stent for the ENX group and 3 thrombosis in the NFH-treated group. No significant differences were found in size of infarction measure with troponin I level (63.1 for ENX and 54.8 for the NFH) or in the left ventricle ejection fraction on hospital discharge (51% for ENX and 49.4% for the NFH).


CONCLUSIONS
Primary angioplasty can be safely sued with the intravenous administration of ENX, no significant differences being found between both treatments in mortality and bleeding complications.
Galeote
Guillermo
G
Unidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología. Hospital Universitario La Paz, Madrid. España. ggaleote.hulp@salud.madrid.org
Moreno
Raúl
R
Sánchez-Recalde
Angel
A
Jiménez-Valero
Santiago
S
Calvo
Luís
L
Rivero
Fernando
F
Gallegos
José F
JF
López de Sa
Estebán
E
Sobrino
José A
JA
López-Sendón
José L
JL
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000627:therapeutic use; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011183:Postoperative Complications / Q000139:chemically induced / Q000401:mortality / Q000517:prevention & control*; D011446:Prospective Studies; D015607:Stents; D013927:Thrombosis / Q000453:epidemiology / Q000517:prevention & control*
D000911:Antibodies, Monoclonal; D017984:Enoxaparin; D007140:Immunoglobulin Fab Fragments; D006493:Heparin; D000077284:Abciximab