Jian-gang WANG, Xiao-kui ZHAO, Hui ZHANG, Zhi-ming ZHAO, Jing HE, Xiao-hui SUN, Li YANG, Yong ZOU, Yao WANG, Xiao-zhen XUE, Rong BAI. Unfractionated heparin and enoxaparin in thrombolysis of acute ST-segment elvation myocardial infarction[J]. Chinese Heart Journal, 2019, 31(3): 278-281. DOI: 10.12125/j.chj.201810044
    Citation: Jian-gang WANG, Xiao-kui ZHAO, Hui ZHANG, Zhi-ming ZHAO, Jing HE, Xiao-hui SUN, Li YANG, Yong ZOU, Yao WANG, Xiao-zhen XUE, Rong BAI. Unfractionated heparin and enoxaparin in thrombolysis of acute ST-segment elvation myocardial infarction[J]. Chinese Heart Journal, 2019, 31(3): 278-281. DOI: 10.12125/j.chj.201810044

    Unfractionated heparin and enoxaparin in thrombolysis of acute ST-segment elvation myocardial infarction

    •   AIM  To compare the differences of unfractionated heparin and enoxaparin treatment of acute ST-segment elevation myocardial infarction in reteplase.
        METHODS  70 patients with acute ST-segment elevation myocardial infarction were divided into groups of A and B, with 35 patients in each group. The reteplase was adopted for thrombolytic therapy for patients in both Group A and Group B. Patients in Group A were injected with 4000 U of unfractionated heparin through the intravenous injection before thrombolysis and then to maintain 12 U/(kg·h) intravenous infusion of 48 h, according to the APTT to adjust the dose of unfractionated heparin, 48 h gradually after the reduction to subcutaneous enoxaparin 40 mg 2 times daily, sequential treatment of 2-7 d or to referral. Patients in Group B were injected with 30 mg of enoxaparin through intravenous injection before the thrombolysis and then subcutaneous injection with 1 mg/kg of enoxaparin after 15 min, every 12 h, treatment 2-7 d or to referral. Comparison of clinical therapy effects of patients in the two groups was performed with statistical analysis conducted on complication probability and analysis on cost-effects.
        RESULTS  At 60 min, the vessel repass rate of patients in Group A was 83%, that of patients in Group B was 57%; at 120 min, the vessel repass rates of patients in Group A and Group B were 100% and 91%, respectively. The vessel repass rate of patients in Group A were higher than that of Group B patients with statistical significance (P < 0.05). The vessel repass time of Group A patients was shorter than that of Group B patients with statistical significance (P < 0.05). The TnI and CK-MB peaks of Group A patients were statistically lower than that of Group B patients (P < 0.05). The total complication probability of Group A patients was statistically lower than Group B patients (P < 0.05). The cost-effect ratio of Group A was lower than Group B, with statistical significance (P < 0.05).
        CONCLUSION  In therapy for acute ST-segment elevation myocardial infarction, if reteplase is selected for thrombolytic therapy, it is more convenient, economical, safer and has better therapeutic effects to adopt unfractionated heparin in sufficient dosage for 48 h and subsequent of use enoxaparin when compared with use of enoxaparin during the entire therapy process.
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