Abstract

GALEOTE, Guillermo et al. Enoxaparin vs. non-fractionated heparin in primary angioplasty of acute myocardial infarction. Med. Intensiva [online]. 2009, vol.33, n.1, pp.1-7. ISSN 0210-5691.

Objective. The objective of this study is to compare the effectiveness of intravenous enoxaparin (ENX) and Non-fractionated Heparin (NFH) in primary angioplasty (PA) of acute myocardial infarction (PA-AMI). Design. A prospective, observational study. Patients and methods. A total of 191 patients admitted at the hospital with the diagnosis of Acute Myocardial Infarction (AMI) and treated with primary angioplasty were included. ENX was used in 91 patients (47.6%) and NFH in 100 patients (52.4%). Choice of treatment was based on the operator's opinion. Patients with cardiogenic shock were excluded. The first group received an intravenous bolus of ENX (0.75-1 mg/Kg) and the second one NFH (70-100 u/Kg), depending on whether it was associated with abciximab or not. In-hospital follow-up was performed, evaluating mortality and bleeding complications of both treatments. Results. In-hospital mortality was 1.1% for the ENX group and 3.3% for NFH one. No significant differences were found in the number of bleeding complications with ENX (4.4%) and NFH (9.0%). There was one subacute thrombosis of stent for the ENX group and 3 thrombosis in the NFH-treated group. No significant differences were found in size of infarction measure with troponin I level (63.1 for ENX and 54.8 for the NFH) or in the left ventricle ejection fraction on hospital discharge (51% for ENX and 49.4% for the NFH). Conclusions. Primary angioplasty can be safely sued with the intravenous administration of ENX, no significant differences being found between both treatments in mortality and bleeding complications.

Keywords : Coronary angioplasty; Enoxaparin; Stent; Acute myocardial infarction.

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