Clinical benefit of low molecular weight heparin for ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention with glycoprotein IIb/IIIa inhibitor.
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.
Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea.
Jung Sun
JS
Cho
Sung-Ho
SH
Her
Ju Yeal
JY
Baek
Mahn-Won
MW
Park
Hyoung Doo
HD
Kim
Myung Ho
MH
Jeong
Young keun
Yk
Ahn
Shung Chull
SC
Chae
Seung Ho
SH
Hur
Taek Jong
TJ
Hong
Young Jo
YJ
Kim
In Whan
IW
Seong
Jei Keon
JK
Chae
Jay Young
JY
Rhew
In Ho
IH
Chae
Myeong Chan
MC
Cho
Jang Ho
JH
Bae
Seung Woon
SW
Rha
Chong Jim
CJ
Kim
Donghoon
D
Choi
Yang Soo
YS
Jang
Junghan
J
Yoon
Wook Sung
WS
Chung
Jeong Gwan
JG
Cho
Ki Bae
KB
Seung
Seung Jung
SJ
Park
D000208:Acute Disease; D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D006470:Hemorrhage; D006493:Heparin / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization; D016017:Odds Ratio; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors* / Q000378:metabolism; D011379:Prognosis; D012042:Registries
D006495:Heparin, Low-Molecular-Weight; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D006493:Heparin