PMID- 22800719
OWN - NLM
STAT- MEDLINE
DCOM- 20121127
LR  - 20120717
IS  - 1875-2128 (Electronic)
IS  - 1875-2128 (Linking)
VI  - 105
IP  - 6-7
DP  - 2012 Jun-Jul
TI  - Comparison of bleeding complications and 3-year survival with 
      low-molecular-weight heparin versus unfractionated heparin for acute myocardial 
      infarction: the FAST-MI registry.
PG  - 347-54
LID - 10.1016/j.acvd.2012.04.002 [doi]
AB  - BACKGROUND: Recent clinical studies suggest that low-molecular-weight heparin 
      (LMWH) could be an effective and safe alternative to unfractionated heparin (UFH) 
      for patients with acute myocardial infarction (AMI). AIMS: To assess the impact 
      of anticoagulant choice (LMWV vs UFH) on bleeding, the need for blood transfusion 
      and 3-year clinical outcomes in AMI patients from the FAST-MI registry. METHODS: 
      FAST-MI was a nationwide registry compiled in France over 1 month in 2005, which 
      included consecutive AMI patients admitted to an intensive care unit less than 48 
      hours from symptom onset in 223 participating centres. RESULTS: A total of 2854 
      patients treated with heparins were included. The risks of major bleeding or 
      transfusion (3.0% vs 7.0%) and in-hospital death (3.2% vs 9.2%) were lower with 
      LMWH compared with UFH, a difference that persisted after multivariable 
      adjustment (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.34-0.76 and OR 
      0.53, 95% CI 0.37-0.76, respectively). Three-year survival, and stroke and 
      reinfarction-free survival risks were also higher with LMWH compared with UFH 
      (adjusted hazard ratio [HR] 0.73, 95% CI 0.61-0.87 and HR 0.73, 95% CI 0.62-0.85, 
      respectively). In two cohorts of patients matched on propensity score for 
      receiving LMWH and with similar baseline characteristics (834 patients per 
      group), major bleeding and transfusion rates were lower while the 3-year survival 
      rate was signi fi cantly higher in patients receiving LMWH. CONCLUSION: Our data 
      suggest that the use of LMWH in AMI patients may have a better benefit/risk 
      profile than UFH, in terms of bleeding, need for transfusion and long-term 
      survival.
CI  - Copyright (c) 2012. Published by Elsevier Masson SAS.
FAU - Puymirat, Etienne
AU  - Puymirat E
AD  - Division of Coronary Artery Disease and Intensive Cardiac Care, Georges-Pompidou 
      European Hospital, Assistance publique-Hopitaux de Paris (AP-HP), Paris-Descartes 
      University, 20, rue Leblanc, 75015 Paris, France. etiennepuymirat@yahoo.fr
FAU - Aissaoui, Nadia
AU  - Aissaoui N
FAU - Silvain, Johanne
AU  - Silvain J
FAU - Bonello, Laurent
AU  - Bonello L
FAU - Cuisset, Thomas
AU  - Cuisset T
FAU - Motreff, Pascal
AU  - Motreff P
FAU - Bataille, Vincent
AU  - Bataille V
FAU - Durand, Eric
AU  - Durand E
FAU - Cottin, Yves
AU  - Cottin Y
FAU - Simon, Tabassome
AU  - Simon T
FAU - Danchin, Nicolas
AU  - Danchin N
CN  - FAST-MI investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT00673036
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120627
PL  - Netherlands
TA  - Arch Cardiovasc Dis
JT  - Archives of cardiovascular diseases
JID - 101465655
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Transfusion
MH  - Chi-Square Distribution
MH  - Disease-Free Survival
MH  - Female
MH  - Fibrinolytic Agents/*adverse effects
MH  - France
MH  - Hemorrhage/*chemically induced/mortality/therapy
MH  - Heparin/*adverse effects
MH  - Heparin, Low-Molecular-Weight/*adverse effects
MH  - Hospital Mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/*drug therapy/mortality
MH  - Odds Ratio
MH  - Propensity Score
MH  - Proportional Hazards Models
MH  - Recurrence
MH  - Registries
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2012/07/18 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/07/18 06:00
PHST- 2012/03/19 00:00 [received]
PHST- 2012/04/10 00:00 [revised]
PHST- 2012/04/18 00:00 [accepted]
PHST- 2012/07/18 06:00 [entrez]
PHST- 2012/07/18 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - S1875-2136(12)00139-8 [pii]
AID - 10.1016/j.acvd.2012.04.002 [doi]
PST - ppublish
SO  - Arch Cardiovasc Dis. 2012 Jun-Jul;105(6-7):347-54. doi: 
      10.1016/j.acvd.2012.04.002. Epub 2012 Jun 27.