Abstract 15651: Comparison of Long-term Clinical Outcomes Between Patients Receiving Low-molecular-weight Heparin and Unfractionated Heparin in Acute Myocardial Infarction
Background: Recent studies show that low molecular weight heparin (LMWH) offers pharmacological and practical advantages over unfractionated heparin (UFH) in acute myocardial infarction (AMI). However, few data exist on the comparison of long-term clinical outcomes between LMWH and UFH in patients with AMI.
Method and Results: We compared the impact of LMWH to UFH therapy on the long-term clinical outcomes in patient with AMI enrolled in the Convergent Registry of Catholic and Chonnam University for AMI (COREA-AMI). A total of 4,073 patients with AMI were consecutively enrolled from January 2004 to December 2009. Patients were divided into the LMWH or UFH groups according to the type of initially administered heparin. The primary clinical endpoint was a composite of the major adverse cardiocerebrovascular events (MACCE) including all-cause death, nonfatal myocardial infarction and stroke during the 6-year followup. 657 patients received LMWH (16.1%) and 3416 (83.9%) UFH initially. During 6 years of followup, patients who received LMWH had lower rate MACCE (23.6% vs. 20.7%, hazard ratio 0.832, 95% CI 0.694-0.998, p=0.048) than the UFH group. The LMWH groups showed lower rate of all-cause death, cardiac death, nonfatal MI, and nonfatal stroke but did not reach statistical significance. After adjusting multiple covariates, treatment with LMWH was associated with a significantly lower rate of MACCE (hazard ratio 0.807, 95% CI 0.661-0.985, p=0.035).
Conclusions: In patients with AMI, initial anticoagulation with LMWH is associated with improved long term clinical outcomes compared to unfractionated heparin.
Figure 1. Cumulative incidence of MACCE
Author Disclosures: I. Choi: None. Y. Sa: None. H. Park: None. J. Byeon: None. S. Ihm: None. B. Hwang: None. J. Kim: None. K. Chang: None. Y. Ahn: None.
- © 2016 by American Heart Association, Inc.