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ȣ - 510930 156 |
| Safety and Efficacy of Low Molecular Weight Heparin, Unfractionated Heparin or Both Combination Therapy in Patients with Acute Non-ST Segment Elevation Myocardial Infarction |
| 고려대학교 구로병원 순환기 내과¹ ,전남대학교 순환기 내과² |
| Kang-yin Chen¹, 나승운¹ ,Zhe Jin¹ ,Yoshiyasu Minami¹ ,나진오¹ ,서순용¹ ,최철웅¹ ,김진원¹ ,김응주¹ ,박창규¹ ,서홍석¹ ,오동주¹ ,정명호² |
Background:Efficacy and safety ofLMWH only,UFH only or combination of 2 antithrombotics in pts with NSTEMI undergoing primary PCI is controversial.We examined impact of these 3 regimens on NSTEMI setting up to 6 months in KAMIR.Method:1,012 NSTEMI pts underwent PCI were enrolled.All pts were randomly assigned to receive one of following regimens:LMWH(60 mg IV or SC bid for 5-7 days) or UFH (5,000 U IV bolus, followed by 24,000 U/day infusion for 2days) or both combination therapy.Bleeding and clinical outcomes of in-hospital,1 and 6 months were compared among 3 groups.All MACE included total death,
revascularization, and myocardial re-infarction.Result:3 groups did not differ in baseline characteristics and had similar clinical efficacy without difference in incidences of cardiac death,total death,revascularization and all MACE during in-hospital,1 month and 6 months f/up period.However,combination group showed a higher incidence of in-hospital major bleeding event (Table).Conclusion:LMWH, UHF and both combination therapy had similar efficacy with low incidences of MACEs in NSTEMI pts undergoing primary PCI.But combination therapy increased incidence of in-hospital major bleeding events.
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Table: In-hospital, 1
month and 6 months clinical outcomes
|
Variable,
n (%) |
LMWH
(n=246) |
UFH
(n=595) |
Combination
(n=171) |
P
value |
|
In-hospital Death |
4
(1.6) |
9
(1.5) |
2
(1.2) |
0.926 |
|
Revascularization
|
7
(2.8) |
15
(2.5) |
6
(3.5) |
0.783 |
|
All
MACE |
13
(5.3) |
24
(4.0) |
8
(4.7) |
0.716 |
|
TIMI-major
bleeding |
0
(0) |
1
(0.2) |
5
(2.9) |
0.001 |
|
At 1 month
Death |
4
(1.7) |
11
(1.9) |
2
(1.2) |
0.826 |
|
Revascularization |
8
(3.3) |
19
(3.2) |
8
(4.7) |
0.637 |
|
??????????????? ?All MACE |
16
(5.7) |
34
(5.8) |
10
(5.9) |
0.994 |
|
At 6 months
Death |
4
(1.7) |
13
(2.2) |
2
(1.2) |
0.646 |
|
Revascularization |
12
(5.0) |
31
(5.3) |
15
(8.9) |
0.175 |
|
All
MACE |
20
(8.3) |
51
(8.7) |
17
(10.1) |
0.811 |
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