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ISSN 0188-2198 (Print)

2000, Number 1

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Rev Mex Cardiol 2000; 11 (1)

Acute effects and long-term results of enoxaparine in patients with unstable angina

Ruesga ZE, Palomo VJA, Estrada GJ, Magaña JA, Waisser RE, Ortega A, Jáuregui AR

Language: Spanish
References: 31
Page: 191-197
PDF size: 122.44 Kb.


ABSTRACT

The use of conventional heparin has been accepted in treatment of ischemic heart disease, it has demonstrated decrease cardiovascular morbid-mortality. The enoxaparine is a new low molecular weight heparin with mechanism of action discretely different as conventional heparin. In this trial we compared 48 patients with diagnosis of unstable angor pectoris and high risk, 24 were treated with conventional heparin 1,000 IU/IV/hr during seven days adjusting TPT (group A) and 24 with enoxaparine 40 mg/12 hrs/subcutaneous during seven days (group B). The cardiovascular risk factors were similar in both groups. All patients received aspirin 150 mg/day. We practiced cardiac scintigraphy on day 1 and day 7 an the ischemic tissue was measured as mild, moderate and severe. There was not difference in cardiac angiographies or interventional procedures in both groups. All patients showed ischemic areas in initial scintigraphy. The analysis of patients with mild ischemic tissue was formed by four patients in group A and four in group B. At seven days, the scintigraphy showed two patients in group A and tree in group B with better myocardial perfusion (p ‹ 0.01). The analysis of patients with moderate ischemic tissue showed that five of fifteen patients in group A were better and seven of fourteen patients in group B were also better (p ‹ 0.01). The group of patients with severe ischemia showed that tree of five patients in group A and five of six patients in group B presented a reduction in isquemic tissue valorated with cardiac scintigraphy (p ‹ 0.01). We found discrete thrombocytopenia in one patient in group A and none in group B. We studied these 48 patients one year and analyzed functional class, acute coronary events, hospitalizations, coronary artery by pass surgery and mortality. There was not difference in functional class and coronary surgery by pass surgery. The acute coronary events in group A was 9 patients/year and 5 patients/year in group B (p ‹ 0.01). The mortality was similar in both groups (3 in group A and 1 in group B). These results suggest this alternate anticoagulant treatment is useful in acute ischemic heart disease.


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