S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
Effects of the early administration of heparin in patients with ST-elevation myocardial infarction treated by primary angioplasty
- Chung, Woo-Young; Han, Mi-Jung; Cho, Young-Seok; Kim, Kwang-Il; Chang, Hyuk-Jai; Youn, Tae-Jin; Chae, In-Ho; Choi, Dong-Ju; Kim, Cheol-Ho; Oh, Byung-Hee; Park, Young-Bae; Choi, Yun-Shik
- Issue Date
- Circ J. 2007 Jun;71(6):862-7.
- *Angioplasty, Balloon; Anticoagulants/*administration & dosage; Enoxaparin/*administration & dosage; Female; Heparin/*administration & dosage; Humans; Male; Middle Aged; Myocardial Infarction/mortality/*therapy; Retrospective Studies; Treatment Outcome
- BACKGROUND: The effect of adjunctive heparin for primary angioplasty in patients with ST-elevation myocardial infarction (STEMI) is not well established, so the authors investigated the effect of early heparin administration in the emergency room (ER) on initial patency of the infarct-related artery (IRA) and on the clinical outcome in STEMI patients. METHODS AND RESULTS: One hundred and twenty consecutive patients who presented with STEMI less than 12 h from pain onset and who were eligible for primary percutaneous coronary intervention were allocated to an early heparin group (heparin administered in ER) or a late heparin group (heparin administered after angiography). In the early heparin group, unfractionated heparin (60 U/kg bolus IV, then 14 U . kg(-1) . h(-1) IV infusion) or enoxaparin (1 mg/kg bolus SC) were administered 144+/-95 min before angioplasty. No significant differences in baseline characteristics were observed between the early heparin group (n=56) and the late heparin group (n=64). However, initial Thrombolysis In Myocardial Infarction (TIMI) flow grade in the IRA was significantly different between the 2 groups (frequency of TIMI 0/1/2/3; 48/4/7/41% vs 70/8/11/11%, early vs late respectively, p=0.002). TIMI 2 or 3 flow was significantly more frequent in the early heparin group than in the late heparin group (48% vs 22%, p=0.002). However, no significant differences were noted between the 2 groups in terms of in-hospital major adverse cardiac events (7% vs 11%, p=0.472) and TIMI major bleeding (2% vs 3%, p=0.639). CONCLUSIONS: In STEMI patients, early heparin therapy administered in the ER improves coronary patency, despite not reaching clinical benefit.
- 1346-9843 (Print)