PMID- 32998166
OWN - NLM
STAT- MEDLINE
DCOM- 20211123
LR  - 20211123
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 69
IP  - 6
DP  - 2021 Sep
TI  - Comparison of Safety between Different Kinds of Heparins in Patients Receiving 
      Intra-Aortic Balloon Counterpulsation.
PG  - 511-517
LID - 10.1055/s-0040-1716390 [doi]
AB  - BACKGROUND:  The present study aimed to compare the effectiveness and safety of 
      low molecular-weight-heparin (LMWH) and unfractionated heparin (UFH) in acute 
      myocardial infarction (AMI) patients receiving intra-aortic balloon 
      counterpulsation (IABP). MATERIALS AND METHODS:  We retrospectively analyzed a 
      total of 344 patients receiving IABP for cardiogenic shock, severe heart failure, 
      ventricular septal rupture, or mitral valve prolapse due to AMI. A total of 161 
      patients received UFH (a bolus injection 70 U/kg immediately after IABP, followed 
      by infusion at a rate of 15 U/kg/hour and titration to for 50 to 70 seconds of 
      activated partial thromboplastin time. A total of 183 patients received LMWH 
      (subcutaneous injection of 1.0 mg/kg every 12 hours for 5 to 7 days and 1.0 mg/kg 
      every 24 hours thereafter). Events of ischemia, arterial thrombosis or embolism, 
      and bleeding during IABP were evaluated. Major bleeding was defined as a 
      hemoglobin decrease by >50 g/L (vs. prior to IABP) or bleeding that caused 
      hemodynamic shock or life-threatening or requiring blood transfusion. RESULTS: 
       Subjects receiving UFH and LMWH did not differ in baseline characteristics. 
      Ischemia was noted in five (3.1%) and two (1.1%) subjects in UFH and LMWH groups, 
      respectively. Arterial thromboembolism occurred in three (1.9%) subjects in the 
      UFH group, but not in the LMWH group. Logistic regression analysis failed to 
      reveal an association between ischemia or bleeding with heparin type. Major 
      bleeding occurred in 16 (9.9%) and six (3.3%) patients in the UFH and LWMH 
      groups, respectively (p = 0.014). Regression analysis indicated that LMWH is 
      associated with less major bleeding. CONCLUSION:  LMWH could reduce the risk of 
      major bleeding in patients receiving IABP. Whether LMWH could reduce arterial 
      thromboembolism needs further investigation.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial-License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Guan, Xiaonan
AU  - Guan X
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Chen, Mulei
AU  - Chen M
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Li, Yanbing
AU  - Li Y
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Zhang, Jianjun
AU  - Zhang J
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Xu, Li
AU  - Xu L
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Sun, Hao
AU  - Sun H
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Zhang, Dapeng
AU  - Zhang D
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Wang, Lefeng
AU  - Wang L
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
FAU - Yang, Xinchun
AU  - Yang X
AD  - Center of Cardiology, Beijing Chaoyang Hospital, Beijing, People's Republic of 
      China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20200930
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - Comparative Effectiveness Research
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/*administration & dosage/adverse effects
MH  - Heparin, Low-Molecular-Weight/*administration & dosage/adverse effects
MH  - Humans
MH  - *Intra-Aortic Balloon Pumping/adverse effects/mortality
MH  - Ischemia/diagnostic imaging/etiology/*prevention & control
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/physiopathology/*therapy
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Thromboembolism/diagnostic imaging/etiology/*prevention & control
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC8455177
COIS- None declared.
EDAT- 2020/10/01 06:00
MHDA- 2021/11/24 06:00
PMCR- 2021/09/01
CRDT- 2020/09/30 20:07
PHST- 2020/10/01 06:00 [pubmed]
PHST- 2021/11/24 06:00 [medline]
PHST- 2020/09/30 20:07 [entrez]
PHST- 2021/09/01 00:00 [pmc-release]
AID - 205825oc [pii]
AID - 10.1055/s-0040-1716390 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2021 Sep;69(6):511-517. doi: 10.1055/s-0040-1716390. Epub 
      2020 Sep 30.