PMID- 12398953
OWN - NLM
STAT- MEDLINE
DCOM- 20021209
LR  - 20190623
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 90
IP  - 9
DP  - 2002 Nov 1
TI  - Safety and effectiveness of combined low molecular weight heparin and 
      glycoprotein IIb/IIIa inhibitors.
PG  - 911-5
AB  - This study examines the safety and efficacy of low molecular weight heparin 
      (LMWH) in combination with platelet glycoprotein (GP) IIb/IIIa inhibitors in 
      patients with acute myocardial infarction (AMI). LMWH has been shown to be as 
      effective as unfractionated heparin (UFH) in the treatment of acute coronary 
      syndrome (ACS), but there are limited data regarding the safety and efficacy of 
      LMWH in combination with GP IIb/IIIa inhibitors. We studied 37,320 patients in 
      the National Registry of Myocardial Infarction 3 who were treated with GP 
      IIb/IIIa receptor antagonists from April 1998 to September 2000. Using univariate 
      analysis, clinical events were compared between 2,482 patients who received LMWH 
      and 34,838 patients who were treated with UFH. To adjust for confounding 
      covariates, a multivariate regression analysis was also performed. Major bleeding 
      rates were 4.0% in patients on LMWH versus 4.2% in patients who were treated with 
      UFH (odds ratio [OR] 0.99, 95% confidence interval [CI] 0.80 to 1.23, p = 0.92). 
      Similarly, there was no significant difference in the occurrence of recurrent 
      myocardial ischemia (OR 0.93, 95% CI 0.82 to 1.06, p = 0.26), and in-hospital 
      death (OR 0.86, 95% CI 0.71 to 1.05, p = 0.14) between groups. There was a trend 
      toward a decreased risk of recurrent AMI in patients who received LMWH compared 
      with those on UFH (1.5% vs 1.9%, OR 0.74, 95% CI 0.53 to 1.05, p = 0.09). LMWH 
      appears to be a safe and effective alternative to UFH in patients with AMI who 
      receive IIb/IIIa inhibitors.
FAU - Kovar, David
AU  - Kovar D
AD  - University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. 
      dkovar@cardio.dom.uab.edu
FAU - Canto, John G
AU  - Canto JG
FAU - Rogers, William J
AU  - Rogers WJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Cardiac Surgical Procedures
MH  - Drug Therapy, Combination
MH  - Electrocardiography
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/drug therapy/epidemiology/surgery
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors/*therapeutic 
      use
MH  - Prevalence
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - United States/epidemiology
EDAT- 2002/10/26 04:00
MHDA- 2002/12/10 04:00
CRDT- 2002/10/26 04:00
PHST- 2002/10/26 04:00 [pubmed]
PHST- 2002/12/10 04:00 [medline]
PHST- 2002/10/26 04:00 [entrez]
AID - S0002914902026528 [pii]
AID - 10.1016/s0002-9149(02)02652-8 [doi]
PST - ppublish
SO  - Am J Cardiol. 2002 Nov 1;90(9):911-5. doi: 10.1016/s0002-9149(02)02652-8.