PMID- 20578166
OWN - NLM
STAT- MEDLINE
DCOM- 20110523
LR  - 20220316
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 77
IP  - 2
DP  - 2011 Feb 1
TI  - Heparin or enoxaparin anticoagulation for primary percutaneous coronary 
      intervention.
PG  - 182-90
LID - 10.1002/ccd.22674 [doi]
AB  - OBJECTIVES: The aim of this study was to compare efficacy and safety outcomes 
      among patients receiving enoxaparin or unfractionated heparin (UFH) while 
      undergoing percutaneous coronary intervention (PCI) for ST-segment elevation 
      myocardial infarction (STEMI). BACKGROUND: Primary PCI (pPCI) for ST elevation 
      has traditionally been supported by UFH. The low molecular weight heparin 
      enoxaparin may provide better outcomes when used for pPCI. METHODS: Consecutive 
      eligible patients (580) undergoing pPCI enrolled in the prospective electronic 
      Pitie-Salpetriere registry of ischemic coronary syndromes (e-PARIS) registry were 
      grouped according to whether they received UFH or enoxaparin as the sole 
      anticoagulant. Logistic regression modeling, propensity-weighted adjustment, and 
      sensitivity analyses were used to evaluate efficacy and safety endpoints for 
      enoxaparin vs. UFH. RESULTS: Enoxaparin was administered to 346 patients and UFH 
      to 234 without ACT or anti-Xa guided dose adjustment. PCI was performed through 
      the radial artery in 90%, with frequent (75%) use of GPIIb/IIIa antagonists. 
      Patients receiving enoxaparin were more likely to be therapeutically 
      anticoagulated during the procedure (68% vs. 50%, P < 0.0001) and were less 
      likely to experience death or recurrent myocardial infarction (MI) in hospital 
      (adjusted OR 0.28 95% CI (0.12-0.68) or by 30 days (adjusted OR 0.35 95% CI 
      0.16-0.81). All cause mortality was also reduced in hospital (adjusted OR 0.32, 
      95% CI (0.12-0.85) and to 30 days (adjusted OR 0.40 95% CI 0.17-0.99). Other 
      ischemic endpoints were similarly reduced with enoxaparin. Thrombolysis in 
      myocardial infarction (TIMI) major bleeding events were numerically fewer among 
      patients receiving enoxaparin (1.2% vs. 2.6%, P = 0.2). CONCLUSIONS: In patients 
      with STEMI presenting for PCI, enoxaparin was associated with a reduction in all 
      ischemic complications, more frequent therapeutic anticoagulation, and no 
      increase in major bleeding when compared against unfractionated heparin. (c) 2010 
      Wiley-Liss, Inc.
CI  - Copyright (c) 2010 Wiley-Liss, Inc.
FAU - Brieger, David
AU  - Brieger D
AD  - Department of Cardiology, Concord Hospital, University of Sydney, Sydney, 
      Australia.
FAU - Collet, Jean-Philippe
AU  - Collet JP
FAU - Silvain, Johanne
AU  - Silvain J
FAU - Landivier, Antoine
AU  - Landivier A
FAU - Barthelemy, Olivier
AU  - Barthelemy O
FAU - Beygui, Farzin
AU  - Beygui F
FAU - Bellemain-Appaix, Anne
AU  - Bellemain-Appaix A
FAU - Mercadier, Anne
AU  - Mercadier A
FAU - Choussat, Remi
AU  - Choussat R
FAU - Vignolles, Nicolas
AU  - Vignolles N
FAU - Costagliola, Dominique
AU  - Costagliola D
FAU - Montalescot, Gilles
AU  - Montalescot G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 9005-49-6 (Heparin)
SB  - IM
CIN - Catheter Cardiovasc Interv. 2011 Feb 1;77(2):191-2. PMID: 21290553
MH  - Aged
MH  - Analysis of Variance
MH  - *Angioplasty, Balloon, Coronary/adverse effects/mortality
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Chi-Square Distribution
MH  - Enoxaparin/adverse effects/*therapeutic use
MH  - Female
MH  - Hemorrhage/chemically induced/prevention & control
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hospital Mortality
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*therapy
MH  - Odds Ratio
MH  - Paris
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Propensity Score
MH  - Prospective Studies
MH  - Registries
MH  - Risk Assessment
MH  - Risk Factors
MH  - Secondary Prevention
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2010/06/26 06:00
MHDA- 2011/05/24 06:00
CRDT- 2010/06/26 06:00
PHST- 2010/06/26 06:00 [entrez]
PHST- 2010/06/26 06:00 [pubmed]
PHST- 2011/05/24 06:00 [medline]
AID - 10.1002/ccd.22674 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2011 Feb 1;77(2):182-90. doi: 10.1002/ccd.22674.