COMPARISON OF ENOXAPARIN AND DALTEPARIN WITH UNFRACTIONATED HEPARIN IN THE TREATMENT OF NON-ST ELEVATED ACUTE CORONARY SYNDROME
AbstractBackground: The term non-ST elevated Acute Coronary Syndrome (ACS) encompasses unstableAngina (USA) and non-ST segment elevated Myocardial Infarction (NSTEMI), both of whichmay end up in death or a fatal/non-fatal Myocardial Infarction (MI). Unfractionated heparin(UFH) has been shown to reduce death and MI in patients with USA and NSTEMI. Of late, therehas been a great interest in the role of low molecular weight heparins (LMWHs) in the twoconditions and they have been found to be at least as effective as or even more effective thanUFH. Methods: A total of 90 patients who presented to CCU of Khyber Teaching Hospital,Peshawar with USA or NSTEMI, from June 2008 to June 2009, were enrolled into the study. Anequal number of patients were randomly assigned to one of the three arms for 5 days each: GroupA received enoxaparin, group B received dalteparin and group C received UFH. The primary endpoints of the study were all cause mortality, STEMI, refractory USA, recurrent USA or a majorbleed. The secondary end point was minor bleeding. Results: At the end of the study, there were 2deaths each in the dalteparin and UFH group, whereas no such event was recorded in theenoxaparin group. Two patients had STEMI in the UFH group but none in the other two groups.Conclusion: LMWHs are far more superior to unfractionated heparin.Keywords: Acute Coronary Syndrome, Coronary Artery Disease, Atherosclerosis, Unstable Angina,Myocardial Infarction, Unfractionated Heparin, low-molecular weight heparin
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