| Randomized comparison of enoxaparin with unfractionated heparin following fibrinolytic therapy for acute myocardial infarction. | |
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MedLine Citation:
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PMID: 11969277 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To compare the efficacy and safety of low molecular weight heparin with unfractionated heparin following fibrinolytic therapy for acute myocardial infarction. METHODS AND RESULTS: Three-hundred patients receiving fibrinolytic therapy following acute myocardial infarction were randomly assigned to low molecular weight heparin as enoxaparin (40 mg intravenous bolus, then 40 mg subcutaneously every 8 h, n=149) or unfractionated heparin (5000 U intravenous bolus, then 30 000 U. 24 h(-1), adjusted to an activated partial thromboplastin time 2-2.5x normal, n=151) for 4 days in conjunction with routine therapy. Clinical and therapeutic variables were analysed, in addition to use of enoxaparin or unfractionated heparin, to determine independent predictors of the 90-day composite triple end-point (death, non-fatal reinfarction, or readmission with unstable angina). The triple end-point occurred more frequently in patients receiving unfractionated heparin rather than enoxaparin (36% vs. 26%; P=0.04). Logistic regression modelling of baseline and clinical variables identified the only independent risk factors for recurrent events as left ventricular failure, hypertension, and use of unfractionated heparin rather than enoxaparin. There was no difference in major haemorrhage between those receiving enoxaparin (3%) and unfractionated heparin (4%). CONCLUSION: Use of enoxaparin compared with unfractionated heparin in patients receiving fibrinolytic therapy for acute myocardial infarction was associated with fewer recurrent cardiac events at 90 days. This benefit was independent of other important clinical and therapeutic factors. |
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Authors:
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S H Baird; I B A Menown; S J Mcbride; T G Trouton; C Wilson |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: European heart journal Volume: 23 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2002 Apr |
Date Detail:
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Created Date: 2002-04-23 Completed Date: 2002-08-21 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 627-32 Citation Subset: IM |
Copyright Information:
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Copyright 2002 The European Society of Cardiology. |
Affiliation:
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Department of Cardiology, Antrim Area Hospital, Antrim, N. Ireland, U.K. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticoagulants / adverse effects, therapeutic use* Endpoint Determination Enoxaparin / adverse effects, therapeutic use* Female Follow-Up Studies Hemorrhage / chemically induced, epidemiology Heparin / therapeutic use* Humans Incidence Male Middle Aged Myocardial Infarction / drug therapy*, epidemiology Predictive Value of Tests Recurrence Risk Factors Thrombolytic Therapy* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Enoxaparin; 9005-49-6/Heparin |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2002 Apr;23(8):591-2
[PMID:
11969270
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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