title: Low molecular weight heparin versus unfractionated heparin in patients with acute non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention with drug-eluting stents.
abstract: BACKGROUND
  Whether low molecular weight heparin (LMWH) enoxaparin is equivalent to unfractionated heparin (UFH) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) remains unclear.
  
  
  METHODS
  A total of 2397 NSTEMI patients who underwent PCI with DES received either LMWH [n=1178, subcutaneous enoxaparin 1 mg/kg, b.i.d., initiated after the patient's arrival and continued until 3-5 days after PCI plus reduced dose of UFH (50-70 U/kg) during PCI] or UFH (n=1219, 24,000U/day infusion, initiated after the patient's arrival and continued until at least 48 h after PCI). The bleeding events and clinical outcomes during in-hospital and at 8 months were compared.
  
  
  RESULTS
  Enoxaparin group had similar incidences of cardiac death, total death, and total major adverse cardiac events (MACE) at 8 months compared with UFH group. The incidences of major and minor bleeding events were also similar between the two groups. Multivariable Cox regression analysis showed that enoxaparin group had similar incidences of cardiac death [adjusted odds ratio (OR) 1.16, 95% confidence interval (CI) 0.64-2.10, p=0.620], total death (adjusted OR 1.08, 95% CI 0.66-1.76, p=0.760), and total MACE (adjusted OR 0.94, 95% CI 0.69-1.28, p=0.692) at 8 months as compared with UFH group.
  
  
  CONCLUSIONS
  Enoxaparin with reduced dose of UFH only during PCI as an adjunctive antithrombotic therapy in NSTEMI patients undergoing PCI with DES was safe and showed comparable 8-month clinical outcomes as compared with UFH alone.
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Li
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Kang-Yin
authors.initials: KY
authors.lastname: Chen
authors.forename: Zhe
authors.initials: Z
authors.lastname: Jin
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Sureshkumar
authors.initials: S
authors.lastname: Ramasamy
authors.forename: Kanhaiya L
authors.initials: KL
authors.lastname: Poddar
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Minami
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Park
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D006493:Heparin