Clinical Benefit of Low Molecular Weight Heparin for ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Glycoprotein IIb/IIIa Inhibitor

Title
Clinical Benefit of Low Molecular Weight Heparin for ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Glycoprotein IIb/IIIa Inhibitor
Author(s)
김영조조정선[조정선]허성호[허성호]백주열[백주열]박만원[박만원]김형두[김형두]정명호[정명호]안영근[안영근]채성철[채성철]허승호[허승호]홍택종[홍택종]성인환[성인환]채제건[채제건]류재영[류재영]채인호[채인호]조명찬[조명찬]배장호[배장호]라승운[라승운]김종짐[김종짐]최동훈[최동훈]장양수[장양수]윤정한[윤정한]정욱성[정욱성]조정관[조정관]승기배[승기배]박승정[박승정]
Keywords
DRUG-ELUTING STENTS; HIGH-RISK PATIENTS; UNFRACTIONATED HEPARIN; RANDOMIZED-TRIAL; PLATELET-AGGREGATION; ENOXAPARIN; SAFETY; ABCIXIMAB; EFFICACY; OUTCOMES
Issue Date
201006
Publisher
KOREAN ACAD MEDICAL SCIENCES
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.25, no.11, pp.1601 - 1608
Abstract
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.
URI
http://hdl.handle.net/YU.REPOSITORY/22363http://dx.doi.org/10.3346/jkms.2010.25.11.1601
ISSN
1011-8934
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의과대학 > 내과학교실 > Articles
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