PMID- 20027109
OWN - NLM
STAT- MEDLINE
DCOM- 20120109
LR  - 20110513
IS  - 1536-3686 (Electronic)
IS  - 1075-2765 (Linking)
VI  - 18
IP  - 3
DP  - 2011 May
TI  - Comparison of low molecular weight heparin with unfractionated heparin during 
      percutaneous coronary interventions: a meta-analysis.
PG  - 180-9
LID - 10.1097/MJT.0b013e3181c1218f [doi]
AB  - To conduct a meta-analysis of the current evidence to evaluate the safety and 
      efficacy of low molecular weight heparin (LMWH) as compared to unfractionated 
      heparin (UFH). Several studies have demonstrated the therapeutic advantage of 
      LMWH over UFH in the medical management of acute coronary syndromes. However, 
      evidence comparing the 2 in percutaneous coronary interventions (PCI) is 
      inconclusive. Previously published meta-analysis did not include some large-scale 
      trials. We performed a systematic literature search for randomized clinical 
      trials that compared LMWH and UFH in urgent or elective PCI. Studies that 
      evaluated efficacy end points [composite of nonfatal myocardial infarction (MI) 
      and death with or without target vessel revascularization] and bleeding end 
      points were included. Studies were excluded if they involved coadministration of 
      thrombolytics. Data were extracted on an intention-to-treat basis. Heterogeneity 
      of the studies was analyzed by Cochran Q statistics. The Mantel-Haenszel 
      fixed-effect model was used to calculate combined relative risks for outcomes 
      where studies were homogenous and the random effect model when the studies were 
      heterogenic. Fourteen studies involving 12,394 patients were included. The 
      efficacy and bleeding risk of LMWH in patients undergoing PCI were comparable 
      with UFH. A subgroup analysis of studies using intravenous or intraarterial 
      administration of LMWH, demonstrated them to be safer than UFH with comparable 
      efficacy. LMWH is at least as efficacious and safe as UFH in patients undergoing 
      PCI. Additionally, evidence suggests that LMWH, when used intravenously, is 
      associated with lower bleeding risks when compared with UFH.
FAU - Kodumuri, Vamsi
AU  - Kodumuri V
AD  - Division of Cardiology, Department of Internal Medicine, Chicago Medical School 
      at Rosalind Franklin University of Medical Sciences, IL, USA. kodv@sinai.org
FAU - Adigopula, Sashi
AU  - Adigopula S
FAU - Singh, Param
AU  - Singh P
FAU - Swaminathan, Paari
AU  - Swaminathan P
FAU - Arora, Rohit
AU  - Arora R
FAU - Khosla, Sandeep
AU  - Khosla S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Coronary Syndrome/*drug therapy/epidemiology/surgery
MH  - Anticoagulants/administration & dosage/adverse effects/*therapeutic use
MH  - Coronary Angiography/drug effects/methods
MH  - Fibrinolytic Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Heart
MH  - Hemorrhage/chemically induced/drug therapy/epidemiology
MH  - Heparin/administration & dosage/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Humans
MH  - Infusions, Intravenous
MH  - Injections, Intravenous
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
EDAT- 2009/12/23 06:00
MHDA- 2012/01/10 06:00
CRDT- 2009/12/23 06:00
PHST- 2009/12/23 06:00 [entrez]
PHST- 2009/12/23 06:00 [pubmed]
PHST- 2012/01/10 06:00 [medline]
AID - 10.1097/MJT.0b013e3181c1218f [doi]
PST - ppublish
SO  - Am J Ther. 2011 May;18(3):180-9. doi: 10.1097/MJT.0b013e3181c1218f.