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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.

 Yong-Jian Li  ;  Seung-Woon Rha  ;  Kang-Yin Chen  ;  Kanhaiya L. Poddar  ;  Zhe Jin  ;  Yoshiyasu Minami  ;  Lin Wang  ;  Qun Dang  ;  Guang-Ping Li  ;  Sureshkumar Ramasamy  ;  Ji-Young Park  ;  Chol Ung Choi  ;  Jin-Won Kim  ;  Eung Ju Kim  ;  'Chang Gyu Park  ;  Hong Seog Seo  ;  Dong Joo Oh  ;  Myung Ho Jeong  ;  Young Keun Ahn  ;  Taek Jong Hong  ;  Jong-Seon Park  ;  Young Jo Kim  ;  Seung Ho Hur  ;  In Whan Seong  ;  Jei Keon Chae  ;  Myeong Chan Cho  ;  Jang Ho Bae  ;  Dong Hoon Choi  ;  Yang Soo Jang  ;  In Ho Chae  ;  Hyo Soo Kim  ;  Chong Jin Kim  ;  Jung Han Yoon  ;  Tae Hoon Ahn  ;  Seung-Jea Tahk  ;  Wook Sung Chung  ;  Ki Bae Seung  ;  Seung Jung Park 
 AMERICAN HEART JOURNAL, Vol.159(4) : 684-1, 2010 
Journal Title
Issue Date
Aged ; Angioplasty, Balloon, Coronary* ; Anticoagulants/administration & dosage* ; Drug Therapy, Combination ; Drug-Eluting Stents ; Electrocardiography ; Enoxaparin/administration & dosage* ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/drug therapy ; Myocardial Infarction/therapy* ; Treatment Outcome
BACKGROUND: Whether low-molecular-weight heparin (LMWH) is superior to unfractionated heparin (UFH) in acute ST-segment 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 < .001), total death (adjusted OR 0.50, 95% CI 0.37-0.68, P < .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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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