Korean J Med.  2002 Aug;63(2):158-168.

The long-term clinical outcomes of low molecular weight heparin in patients with unstable angina underwent percutaneous coronary intervention

• Hong YJ
• Jeong MH
• Lee SH
• Park OY
• Kim JH
• Kim W
• Rhew JY
• Ahn YK
• Cho JG
• Park JC
• Suh SP
• Ahn BH
• Kim SH
• Kang JC

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.

Keyword

Unstable angina; Percutaneous Coronary Intervention; Heparin

MeSH Terms

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
Dalteparin
Heparin
Heparin, Low-Molecular-Weight
Phenobarbital