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Low-molecular-weight heparins vs. unfractionated heparin in the setting of percutaneous coronary intervention for ST-elevation myocardial infarction: a meta-analysis

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dc.contributor.author Navarese, Eliano Pio
dc.contributor.author De Luca, G.
dc.contributor.author Castriota, Fausto
dc.contributor.author Koziński, Marek
dc.contributor.author Gurbel, Paul Alfred
dc.contributor.author Gibson, C. M.
dc.contributor.author Andreotti, Felicita
dc.contributor.author Buffon, Antonino
dc.contributor.author Siller-Matula, Jolanta Maria
dc.contributor.author De Servi, Stefano
dc.contributor.author Sukiennik, Adam
dc.contributor.author Kubica, Jacek
dc.date.accessioned 2013-01-15T12:19:35Z
dc.date.available 2013-01-15T12:19:35Z
dc.date.issued 2013-01-15
dc.identifier.uri http://repozytorium.umk.pl/handle/item/285
dc.description.abstract Summary. Background: The aim of the current study was to perform two separate meta-analyses of available studies comparing low-molecular-weight heparins (LMWHs) vs. unfractionated heparin (UFH) in ST-elevation myocardial infarction (STEMI) patients treated (i) with primary percutaneous coronary intervention (pPCI) or (ii) with PCI after thrombolysis. Methods: All-cause mortality was the prespecified primary endpoint and major bleeding complications were recorded as the secondary endpoints. Relative risk (RR) with a 95%confidence interval (CI) and absolute risk reduction (ARR) were chosen as the effect measure. Results: Ten studies comprising 16 286 patients were included. The median followup was 2 months for the primary endpoint. Among LMWHs, enoxaparin was the compound most frequently used. In the pPCI group, LMWHs were associated with a reduction in mortality [RR (95% CI) = 0.51 (0.41–0.64), P < 0.001, ARR = 3%] and major bleeding [RR (95% CI) = 0.68 (0.49–0.94), P = 0.02, ARR = 2.0%] as compared with UFH. Conversely, no clear evidence of benefits with LWMHs was observed in the PCI group after thrombolysis. Metaregression showed that patients with a higher baseline risk had greater benefits from LMWHs (r = 0.72, P = 0.02). Conclusions: LMWHs were associated with greater efficacy and safety than UFH in STEMI patients treated with pPCI, with a significant relationship between risk profile and clinical benefits. Based on this meta-analysis, LMWHs may be considered as a preferred anticoagulant among STEMI patients undergoing pPCI.
dc.language.iso eng
dc.rights info:eu-repo/semantics/openAccess
dc.subject low-molecular-weight heparin
dc.subject percutaneous coronary intervention
dc.subject ST-elevation myocardial infarction
dc.subject unfractionated heparin
dc.title Low-molecular-weight heparins vs. unfractionated heparin in the setting of percutaneous coronary intervention for ST-elevation myocardial infarction: a meta-analysis
dc.type info:eu-repo/semantics/article


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