PMID- 12686329
OWN - NLM
STAT- MEDLINE
DCOM- 20030507
LR  - 20220309
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 91
IP  - 8
DP  - 2003 Apr 15
TI  - Comparison of effects on markers of blood cell activation of enoxaparin, 
      dalteparin, and unfractionated heparin in patients with unstable angina pectoris 
      or non-ST-segment elevation acute myocardial infarction (the ARMADA study).
PG  - 925-30
AB  - The low-molecular-weight heparins (LMWHs) enoxaparin and dalteparin have shown 
      superior and equivalent efficacy, respectively, over unfractionated heparin (UFH) 
      in patients with unstable angina pectoris (UAP) or non-ST-segment elevation 
      myocardial infarction (NSTEMI). This study aimed to identify markers of blood 
      cell activation that are independent predictors of outcomes at 1 month and to 
      compare the effects of enoxaparin, dalteparin, and UFH on any such markers. In 
      this multicenter, prospective, open-label study, 141 patients with UAP or NSTEMI 
      were randomized to treatment for 48 to 120 hours with enoxaparin (n = 46), 
      dalteparin (n = 48), or UFH (n = 47). Blood samples were taken at the time of 
      randomization and after > or =48 hours of treatment but before catheterization. 
      Multivariate analysis identified increased plasma levels of von Willebrand factor 
      (vWF) and decreased platelet levels of glycoprotein Ib/IX complexes as 
      independent predictors of 1-month adverse outcome (a composite of death, 
      myocardial infarction, and recurrent ischemia). vWF release was strongly related 
      to and may have been released by inflammation as measured by C-reactive protein. 
      Both LMWHs reduced the release of vWF in plasma (as well as C-reactive protein) 
      compared with UFH. Enoxaparin had a more favorable effect on glycoprotein Ib/IX 
      complexes than either dalteparin or UFH. The incidence of the composite clinical 
      efficacy end point was: 13% (enoxaparin), 19% (dalteparin), and 28% (UFH). vWF 
      and its receptor glycoprotein Ib/IX play a key role in acute coronary syndromes. 
      vWF is linked to inflammation and, like glycoprotein Ib/IX, is affected more 
      favorably by the LWMHs than by UFH.
FAU - Montalescot, Gilles
AU  - Montalescot G
AD  - Institut de Cardiologie, Bureau 2-236, Groupe Hospitalier Pitie-Salpetriere 
      Hospital, AP-HP, 47 Boulevard de l'Hopital, 75013 Paris, France. 
      gilles.montalescot@psl.ap-hop-paris.fr
FAU - Bal-dit-Sollier, Claire
AU  - Bal-dit-Sollier C
FAU - Chibedi, Daniela
AU  - Chibedi D
FAU - Collet, Jean-Philippe
AU  - Collet JP
FAU - Soulat, Thierry
AU  - Soulat T
FAU - Dalby, Miles
AU  - Dalby M
FAU - Choussat, Remi
AU  - Choussat R
FAU - Cohen, Ariel
AU  - Cohen A
FAU - Slama, Michel
AU  - Slama M
FAU - Steg, Phillipe-Gabriel
AU  - Steg PG
FAU - Dubois-Rande, Jean-Luc
AU  - Dubois-Rande JL
FAU - Metzger, Jean-Philippe
AU  - Metzger JP
FAU - Tarragano, Francois
AU  - Tarragano F
FAU - Guermonprez, Jean L
AU  - Guermonprez JL
FAU - Drouet, Ludovic
AU  - Drouet L
CN  - ARMADA Investigators
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticoagulants)
RN  - 0 (Biomarkers)
RN  - 0 (Enoxaparin)
RN  - 0 (Platelet Glycoprotein GPIb-IX Complex)
RN  - 0 (von Willebrand Factor)
RN  - 9005-49-6 (Heparin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Angina, Unstable/blood/*drug therapy
MH  - Anticoagulants/*pharmacology/therapeutic use
MH  - Biomarkers/*blood
MH  - Blood Platelets/chemistry
MH  - Dalteparin/*pharmacology
MH  - Enoxaparin/*pharmacology
MH  - Female
MH  - Heparin/*pharmacology/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/blood/*drug therapy
MH  - Platelet Glycoprotein GPIb-IX Complex/*analysis
MH  - Prospective Studies
MH  - von Willebrand Factor/*analysis
EDAT- 2003/04/11 05:00
MHDA- 2003/05/08 05:00
CRDT- 2003/04/11 05:00
PHST- 2003/04/11 05:00 [pubmed]
PHST- 2003/05/08 05:00 [medline]
PHST- 2003/04/11 05:00 [entrez]
AID - S000291490300105X [pii]
AID - 10.1016/s0002-9149(03)00105-x [doi]
PST - ppublish
SO  - Am J Cardiol. 2003 Apr 15;91(8):925-30. doi: 10.1016/s0002-9149(03)00105-x.