Use of Anticoagulants in ST-Segment Elevation Myocardial Infarction Patients; A Focus on Low-Molecular-Weight Heparin

Gurm, Hitinder S.; Eagle, Kim A.

doi:10.1007/s10557-007-6077-4

Cited by 3 publications

(1 citation statement)

References 44 publications

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“… 1 For example, in case of using enoxaparin in patients with ACS, the incidence rates of death, reinfarction, and recurrent angina were reduced after 30 days from 21% to 13% ( P =0.03). 14 …”

Section: Introductionmentioning

confidence: 99%

Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

Byeon

Yang

Choi

2016

TCRM

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BackgroundAcute coronary syndrome (ACS) is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.MethodsThis study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.ResultsAmong 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71%) patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69%) unstable angina patients, 44 (70.97%) non-ST-segment elevation myocardial infarction patients, and 153 (85.96%) ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21%) and 18 (n=105, 21.26%) months after discharge tended to be gradually decreased.ConclusionThe majority of ACS patients in this study received all five guideline-recommended medications at discharge from the hospital. However, the frequency of using all of them had been gradually decreased 3, 6, 12, and 18 months after discharge compared with that at discharge. Careful monitoring of adherence on ACS secondary prevention medications may help improve the outcomes of ACS patients in terms of recurrent ischemic cardiovascular events.

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Section: Introductionmentioning

confidence: 99%

Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

Byeon

Yang

Choi

2016

TCRM

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Coronary Artery Disease

Jahangir¹,

Maria²

2009

Pharmacology and Therapeutics

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Percutaneous Coronary Intervention

Popma¹,

Bhatt²

2012

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine

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Background-The optimal level of platelet inhibition with a glycoprotein (GP) IIb/IIIa antagonist necessary to minimize thrombotic complications in patients undergoing a percutaneous coronary intervention (PCI) is currently unknown. Methods and Results-Five hundred patients undergoing a PCI with the planned use of a GP IIb/IIIa inhibitor had platelet inhibition measured at 10 minutes, 1 hour, 8 hours, and 24 hours after the initiation of therapy with the Ultegra Rapid Platelet Function Assay (Accumetrics). Major adverse cardiac events (MACEs: composite of death, myocardial infarction, and urgent target vessel revascularization) were prospectively monitored, and the incidence correlated with the measured level of platelet function inhibition at all time points. One quarter of all patients did not achieve Ն95% inhibition 10 minutes after the bolus and experienced a significantly higher incidence of MACEs (14.4% versus 6.4%, Pϭ0.006). Patients whose platelet function was Ͻ70% inhibited at 8 hours after the start of therapy had a MACE rate of 25% versus 8.1% for those Ն70% inhibited (Pϭ0.009). By multivariate analysis, platelet function inhibition Ն95% at 10 minutes after the start of therapy was associated with a significant decrease in the incidence of a MACE (odds ratio 0.46, 95% CI 0.22 to 0.96, Pϭ0.04). Conclusions-Substantial

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Use of Anticoagulants in ST-Segment Elevation Myocardial Infarction Patients; A Focus on Low-Molecular-Weight Heparin

Abstract: Enoxaparin is currently the only LMWH with FDA approval for use in STEMI patients and should be considered as a preferable alternative to UFH in STEMI patients treated with fibrinolysis.

Cited by 3 publications

References 44 publications

Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

Coronary Artery Disease

Percutaneous Coronary Intervention

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