Myocardial infarction, with ST-segment elevation : low molecular weight heparins for acute treatment
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2006 Apr 6;354(14):1477-88. Epub 2006 Mar 14 Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation The Use of
low molecular weight heparins (LMWH), enoxaparin, for at least 2 days
As Treatment, Acute
Is better Than
unfractionated heparin (UFH), for the same time
To reduce, at 30 days, death or recurrent infarction: 9.9% enoxaparin VS 12% unfractionated heparin. Major bleeding were a little more frequent with enoxaparin (2.1%) than with UFH (1.4%)
Circulation. 2005 Dec 20;112(25):3855-67. Epub 2005 Dec 12 Meta-Analysis
IN coronary disease, myocardial infarction, ST-segment elevation The Use of
low molecular weight heparins (LMWH), for 4 to 8 days
As Treatment, Acute
Is better Than
placebo or unfractionated heparin (UFH)
To reduce, at 7 days, the risk of reinfarction (1.6% LMWH VS 2.2% placebo, NNT 167) and reduce death (7.8% LMWH VS 8.7% placebo, NNT 111)
Circulation. 2005 Dec 20;112(25):3846-54. Epub 2005 Nov 15 Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation The Use of
low molecular weight heparins (LMWH), for 4 to 8 days
As Treatment, Acute
Is better Than
unfractionated heparin (UFH)
To reduce, at 30 days, cardiovascular death or recurrent myocardial infarction (6.9% with LMWH versus 11.5% with UFH)
JAMA. 2005 Jan 26;293(4):427-35 Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation The Use of
low molecular weight heparins (LMWH), reviparin, for 7 days
As Treatment, Acute
Is better Than
placebo, added to usual medical care
To reduce cardivascular events (composite of death, reinfarction or stroke) at 30 days: 11,8% LMWH VS 13,6% controls; with reductions of 1,5% in mortality and 0,3% in reinfartion, non significant for stroke, 0,1% increase of severe bleeding.