The long-term clinical outcomes of low molecular weight heparin in patients with unstable angina underwent percutaneous coronary intervention.
- Author:
Young Joon HONG
1
;
Myung Ho JEONG
;
Seung Hyun LEE
;
Ok Young PARK
;
Ju Han KIM
;
Weon KIM
;
Jay Young RHEW
;
Young Keun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Soon Pal SUH
;
Byoung Hee AHN
;
Sang Hyung KIM
;
Jung Chaee KANG
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Unstable angina;
Percutaneous Coronary Intervention;
Heparin
- MeSH:
Acute Coronary Syndrome;
Angina, Unstable*;
Coronary Angiography;
Dalteparin;
Diabetes Mellitus;
Follow-Up Studies;
Hemorrhage;
Heparin;
Heparin, Low-Molecular-Weight*;
Hospitalization;
Humans;
Incidence;
Jeollanam-do;
Male;
Multivariate Analysis;
Myocardial Infarction;
Percutaneous Coronary Intervention*;
Phenobarbital;
Prospective Studies;
Stents;
Stroke;
Thrombocytopenia
- From:Korean Journal of Medicine
2002;63(2):158-168
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Antithrombotic therapy with heparin reduces the rate of ischemic events in patients with acute coronary syndrome. Low-molecular-weight heparin (LMWH), given subcutaneously twice daily, has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer and does not require monitoring. METHODS: We prospectively analyzed 180 patients with unstable angina who underwent percutaneous coronary intervention (PCI) between 1999 and 2001 at Chonnam National University Hospital to receive either 120 U/kg of Dalteparin (Fragmin ), administered subcutaneously twice daily (group I; n=90, 61.8+/-8.9 years, male 67.8%), or continuous intravenous unfractionated heparin (group II; n=90, 62.6+/-9.7 years, male 70.0%). During hospitalization and at 6 month after PCI, major adverse cardiac events such as acute myocardial infarction, target vessel revascularization, death, or restenosis were examined. RESULTS: During hospitalization, the incidence of acute myocardial infarction, target vessel revascularization and death were not different between two groups. At follow-up coronary angiography at 6 month after PCI, the incidence of restenosis was lower in group I than in group II (Group I; 26/90, 28.8% vs. Group II; 32/90, 35.6%, p=0.041) and the incidence of target vessel revascularization was lower in group I than in group II (Group I; 21/90, 23.3% vs Group II; 27/90, 30.0%, p=0.039). There was no difference in the rate of major and minor hemorrhage, ischemic stroke and thrombocytopenia between two groups. In the multivariate analysis, factors relating to restenosis were lesion length, postprocedural minimal luminal diameter, CRP on admission, diabetes mellitus, type of hepairn, stent use. CONCLUSION: Dalteparin, a LMWH, is superior to standard unfractionated heparin for reducing restenosis rate and target vessel revascularization without increasing bleeding complications.
