[Enoxaparin vs. non-fractionated heparin in primary angioplasty of acute myocardial infarction]. / Eficacia y seguridad de la enoxaparina en la angioplastia primaria. Análisis comparativo con la heparina no fraccionada.

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.

Eficacia y seguridad de la enoxaparina en la angioplastia primaria. Análisis comparativo con la heparina no fraccionada / Enoxaparin vs. non-fractionated heparin in primary angioplasty of acute myocardial infarction

Objetivo. El objetivo de este estudio es comparar el efecto de la enoxaparina (ENX) y la heparina no fraccionada (HNF) intravenosas en la angioplastia primaria (AP) del infarto agudo de miocardio (IAMCEST). Diseño. Estudio prospectivo observacional. Pacientes y método. Se incluyó en el estudio a 191 pacientes con IAMCEST a los que se había realizado AP. En 91 (47,6%) se utilizó ENX y en 100 (52,4%), HNF. La elección del tratamiento se realizó a criterio del operador. Se excluyó a los pacientes con shock cardiogénico. Los pacientes recibieron un bolo intravenoso de ENX (0,75 o 1 mg/kg) o HNF (70 o 100 U/kg), dependiendo si se lo combinaba con abciximab o no. Se realizó seguimiento intrahospitalario evaluando la mortalidad y las complicaciones hemorrágicas de ambos tratamientos. Resultados. La mortalidad hospitalaria fue del 1,1% en el grupo ENX y del 3,3% en el grupo HNF (p = 0,359). Tampoco se encontraron diferencias significativas en el número de complicaciones hemorrágicas con ENX (4,4%) y con HNF (9%). Hubo 1 trombosis aguda o subaguda de stent con ENX y 3 con HNF. No se encontraron diferencias significativas en el tamaño del infarto medido con troponina I (63,1 con ENX y 54,8 con HNF) ni en la fracción de eyección del ventrículo izquierdo al alta hospitalaria (el 51% con ENX y el 49,4% con HNF). Conclusiones. La AP puede realizarse de forma segura con la administración intravenosa de ENX, pues no se ha encontrado diferencias significativas entre los dos tratamientos ni en mortalidad ni en complicaciones hemorrágicas (AU)

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