Use of unfractionated heparin and a low-molecular-weight heparin following thrombolytic therapy for acute ST-segment elevation myocardial infarction

Abstract

Abstract: Objective To compare the efficacy and safety of unfractionated heparin with a low -molecular-weight heparin (par-naparin) in the management of anticoagulation fol lowing thrombolytic therapy for acute ST-segment elevation myocardial in-farctio n.Methods One hundred and eighty-six patients with acute ST-segment elevation m yocardial infarction undergoing thrombolytic therapy were randomly assigned to receive either unfractionated heparin (100 U/kg·b.w. intravenous bolus, 1000U/h continuous infusion for 3 days just 12h after thrombolysis to maintain the activated partial thromboplastin time at 1.5 to 2.0 times as normal, then subcut aneous 7500U every 12h for 4 days, n=90) or parnaparin (0.4ml subcutaneously every 12h for 7 days 12h after thrombolysis, n=96) in conjunction with routi ne therapy. The patients enrolled stayed in hospital for at least 14 days and were followed for 45 days after admission into the hospital.Results The composit e triple end-point (death, recurrent myocardial infarction, emergency revascula rization assessed at 2, 7, 14, 45 days) was significantly reduced in pa-tients receiving parnaparin(42.22% vs 37.08%, P=0.03).Compared with unfractionated he parin group, the incidences of hemorrhage (10.00% vs3.13%, P=0.06)and heparin -induced thrombocytopenia (3.33% vs 0, P=0.07) were also lower in par-naparin gro up.Conclusion Parnaprin is more effective in reducing composite cardiac events, hemorrhage and heparin-in-duced thrombocytopenia at least in 45 days as compare d with unfractionated heparin during anticoagulation following throm-bolytic the rapy for acute ST-segment elevation myocardial infarction.

CLC Number:

R542.22

ZHANG Ye, WANG Xu-kai, YANG Cheng-ming. Use of unfractionated heparin and a low-molecular-weight heparin following thrombolytic therapy for acute ST-segment elevation myocardial infarction[J]. Journal of Southern Medical University, 2004, 24(01): 81-84.

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