Primary percutaneous coronary intervention for ST-elevation myocardial infarction using an intravenous and subcutaneous enoxaparin low molecular weight heparin regimen

J Thromb Thrombolysis. 2008 Oct;26(2):85-90. doi: 10.1007/s11239-008-0258-2. Epub 2008 Jul 18.

Abstract

Background: Enoxaparin use in PCI has been investigated, however its role in primary PCI is less known.

Objective: To evaluate the role of combination IV + SC enoxaparin in primary PCI in STEMI.

Methods: 83 consecutive patients with STEMI who underwent primary PCI between January 1, 2005 and January 15, 2008 were included. Anticoagulation was based on our institution's STEMI protocol; either IV + SC enoxaparin, or IV unfractionated heparin (UFH). Clinical endpoints included MACE, bleeding and net adverse cardiac events (NACE).

Results: 45 patients received UFH and 37 received IV + SC enoxaparin. There was no difference in the rate of mortality, MACE, or NACE. There was a trend toward more TIMI major and GUSTO moderate and severe bleeding in the UFH group.

Conclusions: Application of IV + SC enoxaparin strategy for primary PCI in STEMI appears both safe and efficacious. A prospective randomized trial will be necessary to evaluate the safety and efficacy more thoroughly.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control*
  • Enoxaparin / administration & dosage*
  • Enoxaparin / adverse effects
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / adverse effects
  • Hemorrhage / chemically induced
  • Heparin / administration & dosage*
  • Heparin / adverse effects
  • Humans
  • Injections, Intravenous
  • Injections, Subcutaneous
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Pilot Projects
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Enoxaparin
  • Fibrinolytic Agents
  • Heparin