|
|
|
| * These
news are selected from 'TCT Daily (2004)' provided
by Cardiovascular Research Foundation (CRF). |
Rates of death or myocardial
infarction appeared comparable between high-risk
patients who were managed with either enoxaparin
or unfractionated heparin for percutaneous coronary
interventions, according to results from the SYNERGY
Trial presented by Neil Kleiman, MD, one of the
lead investigators on the trial.
Patients managed with enoxaparin experienced a slight
excess of bleeding using the TIMI grading scale.
The study included 4,687 high-risk patients undergoing
PCI after randomization. The patients were randomized
to receive either IV heparin (60 mU/kg bolus with
target a PPT of 50 to70 seconds) or enoxaparin (1
mg/kg subcutaneously every 12 hours, plus an additional
3 mg/kg IV at the time of PCI if the procedure was
performed more than eight hours after the last subcutaneous
dose). The primary composite endpoint was composite
death or MI at 30 days.
Patients who crossed over from one form of heparin
to another after randomization raised a warning
signal about the hazards of increased bleeding as
a result of changing heparin modalities during the
course of hospitalization, Kleiman said.
He advised caution in treating patients who undergo
PCI within the first few hours after enoxaparin
therapy is begun. However, if the course of medical
management is to be substantial, initial therapy
with enoxaparin could be beneficial, he said. |
|
|
|
|
|
