The Long-Term Clinical Outcomes of Low Molecular Weight Heparin Combined with Platelet Glycoprotein IIb/IIIa Inhibitor in Patients with Acute Coronary Syndrome.
10.4070/kcj.2003.33.7.559
- Author:
Ju Han KIM
;
Myung Ho JEONG
;
Jay Young RHEW
;
Bora YANG
;
Du Sun SIM
;
Sang Yup LIM
;
Young Joon HONG
;
Ok Young PARK
;
Woo Seok PARK
;
Weon KIM
;
Young Keun AHN
;
Yong MOON
;
Jeong Gwan CHO
;
Jong CHUN
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Thrombosis;
Platelets;
Angioplasty;
Prognosis
- MeSH:
Acute Coronary Syndrome*;
Angina, Unstable;
Angioplasty;
Blood Platelets*;
Coronary Artery Bypass;
Dalteparin;
Follow-Up Studies;
Glycoproteins*;
Hemorrhage;
Heparin;
Heparin, Low-Molecular-Weight*;
Humans;
Myocardial Infarction;
Percutaneous Coronary Intervention;
Platelet Activation;
Prognosis;
Thrombosis;
Transplants;
Troponin
- From:Korean Circulation Journal
2003;33(7):559-567
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Platelet activation and aggregation, with resultant arterial thrombus formation, play pivotal roles in the pathophysiology of acute coronary syndrome (ACS). The efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin, or low molecular heparin (LMWH), in the management of ACS were evaluated. SUBJECTS AND MEHTODS: One hundred seventeen patients (60.8+/-10.9 years, 76 male), with unstable angina or non-ST elevation myocardial infarction, who had ST-T changes and elevated troponin, were divided into 4 groups : Group I (n=30 : heparin alone), Group II (n=28 : LMWH, dalteparin alone), Group III (n=29 : tirofiban combined with heparin) and Group IV (n=30 : tirofiban with LMWH). The major adverse cardiac events (MACE) among the 4 groups, during 6-month clinical follow-ups, were compared. RESULTS: Percutaneous coronary intervention, or a coronary artery bypass graft, was performed in 23, 19, 19 and 22 patients from Groups I, II, III and IV, respectively (p=0.87). A minor bleeding complication developed in 2 (6.7%), 1 (3.6%), 1 (3.4%) and 2 patients (6.7%) in groups I, II, III and IV, respectively (p=0.79). During the six-month follow-up MACE occurred in 7 (30.4%), 6 (31.6%), 3 (15.8%) and 4 patients (18.2%) in groups I, II, III and IV, respectively (p=0.02 : Group I and II vs. Group III and IV). CONCLUSION: Tirofiban combined with LMWH is safe and may improve the long-term prognosis of patients with ACS.
