PMID- 16467747
OWN - NLM
STAT- MEDLINE
DCOM- 20060504
LR  - 20181203
IS  - 0026-4725 (Print)
IS  - 0026-4725 (Linking)
VI  - 54
IP  - 1
DP  - 2006 Feb
TI  - Subcutaneous enoxaparin following thrombolysis and intravenous unfractionated 
      heparin in ST-elevation acute myocardial infarction: safety and efficacy of low 
      vs full dose.
PG  - 131-7
AB  - AIM: In ST-segment elevation myocardial infarction (STEMI) treated with 
      fibrin-specific thrombolytic agents, early intravenous unfractionated heparin 
      (UFH) is warranted. Low molecular weight heparin Enoxaparin currently represents 
      an alternative to UFH, to be used until hospital discharge. Since optimal dosing 
      of subcutaneous Enoxaparin is not standardized, we conducted an observational 
      study to compare safety and efficacy of low (4,000 U once daily) vs full dose 
      (100 U/kg twice daily) regimens. METHODS: All STEMI patients successfully treated 
      with tenecteplase and intravenous UFH and referred to the Catheterization 
      Laboratory between June 2002-November 2003 for predischarge coronary angiography, 
      were evaluated. The primary end-point was the composite of hemorrhages and 
      residual angina/reinfarction during Enoxaparin administration, whereas secondary 
      end-points were occurrence of venous thromboembolism (VTE) during Enoxaparin 
      administration, and infarct-related artery (IRA) patency rate at predischarge 
      coronary angiography. RESULTS: Out of 123 patients, 57 (M/F 45/12, mean age 
      65.8+/-8.1 years) received low dose, and 66 (men/women 45/21, mean age 
      62.6+/-11.8 years) full dose subcutaneous Enoxaparin. The incidence of the 
      composite primary end-point was comparable in both groups (19% vs 26%; P=NS). 
      Also, null was the occurrence of VTE, whereas the IRA patency rate did not 
      significantly differ in the 2 groups (84% vs 86% TIMI 3 and 11% vs 9% TIMI 2 flow 
      grades; P=NS). CONCLUSIONS: In patients with STEMI undergoing successful 
      recanalization with tenecteplase and intravenous UFH, low dose subcutaneous 
      Enoxaparin appears preferable to full dose, in the light of comparable safety and 
      clinical efficacy and superior easiness of use.
FAU - Rubboli, A
AU  - Rubboli A
AD  - Division of Cardiology, Ospedale Maggiore, Bologna, Italy. 
      andrearubboli@libero.it
FAU - Gatti, C
AU  - Gatti C
FAU - Spinolo, L
AU  - Spinolo L
FAU - Parollo, R
AU  - Parollo R
FAU - Spitali, G
AU  - Spitali G
FAU - Maresta, A
AU  - Maresta A
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - Italy
TA  - Minerva Cardioangiol
JT  - Minerva cardioangiologica
JID - 0400725
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - WGD229O42W (Tenecteplase)
SB  - IM
MH  - Aged
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Enoxaparin/administration & dosage/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage/*therapeutic use
MH  - Heart Conduction System/*physiopathology
MH  - Heparin/administration & dosage/*therapeutic use
MH  - Humans
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/*drug therapy/physiopathology
MH  - Prospective Studies
MH  - Tenecteplase
MH  - *Thrombolytic Therapy
MH  - Tissue Plasminogen Activator/*therapeutic use
MH  - Treatment Outcome
EDAT- 2006/02/10 09:00
MHDA- 2006/05/05 09:00
CRDT- 2006/02/10 09:00
PHST- 2006/02/10 09:00 [pubmed]
PHST- 2006/05/05 09:00 [medline]
PHST- 2006/02/10 09:00 [entrez]
PST - ppublish
SO  - Minerva Cardioangiol. 2006 Feb;54(1):131-7.