Abstract | OBJECTIVES: BACKGROUND: METHODS: A total of 219 patients with unstable angina entered the study at a mean time of 6.17 h after the last episode of rest pain. Patients were randomized to receive aspirin (200 mg/day [group A]), aspirin plus regular heparin (400 IU/kg body weight per day intravenously and titered by activated partial thromboplastin time [group B]) and aspirin plus low molecular weight heparin (214 UIC/kg anti-Xa twice daily subcutaneously [group C]). The major end points determined for the in-hospital period were 1) recurrent angina, 2) myocardial infarction, 3) urgent revascularization, 4) major bleeding, and 5) death. Minor end points were 1) silent myocardial ischemia, and 2) minor bleeding. Event rates were tested by chi-square analysis. RESULTS: Recurrent angina occurred in 37%, 44% and 21% of patients in groups A, B and C, respectively, and was significantly less frequent in group C than in either group A (odds ratio 2.26, 95% confidence interval [CI] 1 to 5.18, p = 0.03) or group B (odds ratio, 3.07, 95% CI 1.36 to 7.00, p = 0.002). Nonfatal myocardial infarction was present in seven patients in group A, four in group B and none in group C (group B vs. A, p = 0.5; group C vs. A, p = 0.01). Urgent revascularization was performed in nine patients in group A, seven in group B and one in group C (C vs. A, p = 0.01). Two episodes of major bleeding occurred in group B. Silent myocardial ischemia was present in 38%, 41% and 25% of patients in groups A, B and C, respectively, and was significantly less frequent in group C than group B (odds ratio 2.12, 95% CI 0.97 to 4.69, p = 0.04). Minor bleeding was detected in 10 patients in group B, 1 patient in group C (B vs. C, p = 0.01) and no patient in group A (A vs. B, p = 0.003). CONCLUSIONS:
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Authors | E P Gurfinkel, E J Manos, R I Mejaíl, M A Cerdá, E A Duronto, C N García, A M Daroca, B Mautner |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 26
Issue 2
Pg. 313-8
(Aug 1995)
ISSN: 0735-1097 [Print] United States |
PMID | 7608429
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Heparin, Low-Molecular-Weight
- Heparin
- Aspirin
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Topics |
- Adult
- Aged
- Angina, Unstable
(drug therapy, prevention & control)
- Aspirin
(adverse effects, therapeutic use)
- Chi-Square Distribution
- Drug Therapy, Combination
- Female
- Hemorrhage
(chemically induced)
- Heparin
(adverse effects, therapeutic use)
- Heparin, Low-Molecular-Weight
(adverse effects, therapeutic use)
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(prevention & control)
- Myocardial Ischemia
(drug therapy, prevention & control)
- Odds Ratio
- Prospective Studies
- Recurrence
- Single-Blind Method
- Treatment Outcome
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