Cor Vasa 2004, 45(5):203-208
Low-molecular weight or unfractionated heparin in PTCA for stable angina. A randomized study
- 1 Kardio-Troll, Pracoviště invazivní kardiologie, Nemocnice Pardubice, Pardubice
- 2 Kardiochirurgická klinika, Fakultní nemocnice, Hradec Králové
- 3 Kardiocentrum, Nemocnice Podlesí, Třinec, Česká republika
Aim of the study:
Inhibition of thrombocyte activity during PTCA is of essential importance for reducing ischemic complications of the procedure. Unfractionated heparin (UFH) enhances thrombocyte aggregation, whilst low-molecular weight heparin (LMWH) has a minimal effect on thrombocyte activity. The aim of the study was to determine whether or not the superior pharmacological characteristics of LMWH would result in reducing the rate of PTCA-related ischemic complications. A secondary aim of the study was to compare the incidence of local PTCA-related bleeding complications during treatment with UFH and LMWH.
Method:
A multicentric randomized prospective study evaluating 340 patients treated by PTCA for stable angina. A statistical comparison of groups treated during PTCA with either UFH (n = 170) or LMWH (n = 170). Both groups were comparable in terms of baseline clinical and angiographic parameters.
Results:
No serious cardiovascular events (death, myocardial infarction, and emergency revascularization procedures). The incidence of minimal myocardial lesion (isolated post-PTCA increase in troponin I) was comparable in either group (LMWH 10.4% vs. UFH 14.3%, p = NS). Local bleeding complications were comparable in both groups.
Conclusion:
Coronary angioplasty for stable angina is associated with minimal risk for serious ischemic complications. Use of LMWH heparin during PTCA will not reduce the incidence of minimal myocardial lesion and its safety is comparable to that of UFH.
Keywords: Coronary angioplasty (PTCA); Low-molecular weight heparin (LMWH); PTCA-related ischemic complications; PTCA-related bleeding complications
Published: May 1, 2004 Show citation