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Clinical Benefit of Low Molecular Weight Heparin for ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Glycoprotein IIb/IIIa Inhibitor

Authors
Cho, Jung SunHer, Sung-HoBaek, Ju YealPark, Mahn-WonKim, Hyoung DooJeong, Myung HoAhn, Young KeunChae, Shung ChullHur, Seung HoHong, Taek JongKim, Young JoSeong, In WhanChae, Jei KeonRhew, Jay YoungChae, In HoCho, Myeong ChanBae, Jang HoRha, Seung WoonKim, Chong JimChoi, DonghoonJang, Yang SooYoon, JunghanChung, Wook SungCho, Jeong GwanSeung, Ki BaePark, Seung Jung
Issue Date
11월-2010
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Myocardial Infarction; Heparin; Blood Platelets; Prognosis
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.25, no.11, pp.1601 - 1608
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
25
Number
11
Start Page
1601
End Page
1608
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/115355
DOI
10.3346/jkms.2010.25.11.1601
ISSN
1011-8934
Abstract
The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
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