Safety of enoxaparin versus unfractioned heparin in patients undergoing percutaneous coronary intervention using drug eluting stents: A pilot study

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Shiraz University of Medical Sciences
Background: Unfractioned heparin (UFH) is the standard antithrombotic agent in elective percutaneous coronary intervention (PCI), but has its own limitations. Several studies have suggested intravenous enoxaparin as a safe and effective alternative but most of them are uncontrolled. Our main goal was to evaluate the safety of enoxaparin over UFH in PCI patients undergoing coronary stenting by drug eluting stents (DES). Methods: We randomly assigned 195 patients undergoing PCI using DES to receive either 0.75 mg enoxaparin per kilogram of body weight or 10000 IU unfractioned heparin. The primary end point was the incidence of major or minor bleeding . The secondary end point was the incidence of acute coronary events (ST-elevation myocardial infarction, non ST-elevation myocardial infarction,and unstable angina) in the first 24 hours after PCI. Results: The rate of major and minor bleedings was similar in the first 24 hours after procedure between enoxaparin group and UFH group ( P value>0.05). The incidence of acute coronary events and mortality was also similar between two arms. Conclusion: In DES based PCI , a single intravenous bolus of 0.75 mg of enoxaparin per kilogram is associated with similar rate of bleeding as compaired with UFH. Also the rates of ischemic events are not different for enoxaparin and UFH however larger trials are needed for definit conclusion.