Document Detail


Randomized comparison of enoxaparin with unfractionated heparin following fibrinolytic therapy for acute myocardial infarction.
MedLine Citation:
PMID:  11969277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S H Baird; I B A Menown; S J Mcbride; T G Trouton; C Wilson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-23     Completed Date:  2002-08-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  627-32     Citation Subset:  IM    
Copyright Information:
Copyright 2002 The European Society of Cardiology.
Affiliation:
Department of Cardiology, Antrim Area Hospital, Antrim, N. Ireland, U.K.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anticoagulants; 0/Enoxaparin; 9005-49-6/Heparin
Comments/Corrections
Comment In:
Eur Heart J. 2002 Apr;23(8):591-2   [PMID:  11969270 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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