PMID- 17345826
OWN - NLM
STAT- MEDLINE
DCOM- 20070424
LR  - 20190922
IS  - 0025-8105 (Print)
IS  - 0025-8105 (Linking)
VI  - 59
IP  - 9-10
DP  - 2006 Sep-Oct
TI  - [The use of low molecular weight heparins in patients with acute ST-elevated 
      myocardial infarction].
PG  - 476-81
AB  - INTRODUCTION According to the published guidelines for the management of acute 
      coronary syndromes (ACS), treatment of acute ST-elevated myocardial infarction is 
      based on rapid revascularization, either mechanical or pharmacological. 
      Pharmacological revascularization consists of fibrinolytic therapy with 
      antiplatelet and anticoagulant therapy. In regard to the anticoagulant therapy, 
      low molecular weight heparins (LMWHs) are of special importance. LMWHs cause less 
      complications (bleeding, thrombocytopenia, better bioviability) in comparison 
      with unfractionated heparin (UFH). Some studies on use of LMWHs in ACS, show that 
      LMWHs are equally efficient and safe as UFH, causing less complications 
      (different types of hemorrhagic complications) (ESSENCE, TIMI 11B (enoxaparin), 
      FRAXIS-fraxiparin), whereas some studies show better efficacy and safety of 
      enoxaparin in therapy of acute ST-elevated myocardial infarction (ASSENT 3, 
      ASSENT 3 PLUS, HART II, AMI-SK). INCLUSION CRITERIA: acute anterior myocardial 
      infarction with ST-elevation, first myocardial infarction, no other structural 
      heart defects, no signs of cardiogenic shock. Our study included 30 patients 
      receiving fibrinolytic therapy with streptokinase, antiplatelet therapy and LMWH 
      during 6 days, and 30 patients receiving UFH instead of LMWH. The follow-up 
      period lasted for 6 months. RESULTS: Significantly more patients receiving 
      unfractionated heparin presented with major adverse cardiac events (73.3%) in 
      regard to patients in the study group (44.2% nadroparin, 39.8% enoxaparin) (p = 
      0.025). In the group receiving UFH, 6.7% patients had hemorrhagic complications, 
      while none of patients receiving LMWHs. An equal number of patients died. 
      CONCLUSION: Patients who were treated with LMWHs experienced less major adverse 
      cardiac events and lower mortality. None suffered from hemorrhagic complications.
FAU - Petrovic, Milovan
AU  - Petrovic M
AD  - Institut za kardiovaskularne bolesti, Sremska Kamenica, Klinika za kardiologiju. 
      nsbim@Eunet.yu
FAU - Panic, Gordana
AU  - Panic G
FAU - Canji, Tibor
AU  - Canji T
FAU - Srdanovic, Ilija
AU  - Srdanovic I
FAU - Ivanovic, Vladimir
AU  - Ivanovic V
FAU - Benc, Dragan
AU  - Benc D
LA  - srp
PT  - English Abstract
PT  - Journal Article
PL  - Serbia
TA  - Med Pregl
JT  - Medicinski pregled
JID - 2985249R
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - *Electrocardiography
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Myocardial Infarction/*drug therapy/mortality/physiopathology
MH  - Survival Rate
MH  - *Thrombolytic Therapy
EDAT- 2007/03/10 09:00
MHDA- 2007/04/25 09:00
CRDT- 2007/03/10 09:00
PHST- 2007/03/10 09:00 [pubmed]
PHST- 2007/04/25 09:00 [medline]
PHST- 2007/03/10 09:00 [entrez]
AID - 10.2298/mpns0610476p [doi]
PST - ppublish
SO  - Med Pregl. 2006 Sep-Oct;59(9-10):476-81. doi: 10.2298/mpns0610476p.