دورية أكاديمية

Enoxaparin in Primary and Facilitated Percutaneous Coronary Intervention A Formal Prospective Nonrandomized Substudy of the FINESSE Trial (Facilitated INtervention with Enhanced Reperfusion Speed to Stop Events)

التفاصيل البيبلوغرافية
العنوان: Enoxaparin in Primary and Facilitated Percutaneous Coronary Intervention A Formal Prospective Nonrandomized Substudy of the FINESSE Trial (Facilitated INtervention with Enhanced Reperfusion Speed to Stop Events)
المؤلفون: Montalescot, Gilles, Ellis, Stephen G., de Belder, Mark A., Janssens, Luc, Katz, Olivier, Pluta, Wladyslaw, Ecollan, Patrick, Tendera, Michal, van Boven, Ad J., Widimsky, Petr, Andersen, Henning R., Betriu, Amadeo, Armstrong, Paul, Brodie, Bruce R., Herrmann, Howard C., Neumann, Franz-Josef, Effron, Mark B., Lu, Jiandong, Barnathan, Elliot S., Topol, Eric J.
بيانات النشر: ELSEVIER SCIENCE INC
سنة النشر: 2010
المجموعة: The University of Queensland: UQ eSpace
مصطلحات موضوعية: Elevation-Myocardial-Infarction, Molecular-Weight Heparin, Activated Clotting Time, Unfractionated Heparin, Randomized-Trials, Task-Force, Metaanalysis, Angioplasty, Therapy, Guidelines
الوصف: Objectives The aim of this study was to assess the risk-benefit of enoxaparin (Sanofi-Aventis, Paris, France) in primary percutaneous coronary intervention (PCI).Background Randomized studies have demonstrated the superiority of enoxaparin over unfractionated heparin (UFH) in acute ST-segment elevation myocardial infarction (STEMI) treated with fibrinolytics.Methods In the FINESSE (Facilitated INtervention with Enhanced Reperfusion Speed to Stop Events) trial a double-blind, placebo-controlled study-2,452 patients with STEMI were randomized to primary PCI or facilitated PCI with abciximab alone or with half-dose reteplase. In this prospective FINESSE sub-study, centers pre-specified use of either enoxaparin (0.5 mg/kg intravenous [IV], 0.3 mg/kg subcutaneous [SC]) or UFH (40 U/kg IV, 3,000 U maximum) with PCI. A logistic-regression model and a propensity multivariate model, both adjusted for baseline variables, were used to evaluate primary safety and secondary efficacy end points for enoxaparin versus UFH.Results Enoxaparin was administered to 759 patients and UFH to 1,693 patients. Nonintracranial Thrombolysis In Myocardial Infarction (TIMI) major/minor bleeding was not significantly different, but lower nonintracranial TIMI major bleeding was found with enoxaparin (2.6% vs. UFH 4.4%, logistic-regression adjusted odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.31 to 0.99, p = 0.045), whereas intracranial hemorrhage was similar (0.27% vs. 0.24%, adjusted OR: 1.03; 95% CI: 0.11 to 9.68, p = 0.980). Lower death, myocardial infarction, urgent revascularization, or refractory ischemia through 30 days was also associated with enoxaparin (5.3%) versus UFH (8.0%, adjusted OR: 0.47, 95% CI: 0.31 to 0.72, p = 0.0005) as was all-cause mortality through 90 days (3.8% vs. 5.6%, respectively, adjusted OR: 0.59, 95% CI: 0.35 to 0.99, p = 0.046). End points evaluating the net clinical benefit also significantly favored enoxaparin over UFH.Conclusions Enoxaparin seems to be associated with a lower risk of cardiovascular ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
تدمد: 1936-8798
العلاقة: orcid:0000-0003-4050-5030
الإتاحة: https://doi.org/10.1016/j.jcin.2009.11.012Test
https://espace.library.uq.edu.au/view/UQ:4b84279Test
رقم الانضمام: edsbas.CB96977A
قاعدة البيانات: BASE