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Comparison of enoxaparin and unfractionated heparin in coronary angioplasty.

INTRODUCTION
Recent studies have shown that enoxaparin may be equally as safe and effective as unfractionated heparin during a coronary angioplasty procedure. The aim of this study was to investigate whether enoxaparin can be used effectively and safely in place of unfractionated heparin in patients undergoing emergency or programmed coronary angioplasty, regardless of the use of platelet glycoprotein IIb/IIIa inhibitors.


METHODS
We compared two series of consecutive patients, who received unfractionated heparin (n = 217) or enoxaparin (n = 116) during emergency or programmed angioplasty, regardless of age, weight, renal function and the coadministration of platelet glycoprotein IIb/IIIa inhibitors. In the patients who received enoxaparin the arterial sheaths were removed immediately after the procedure.


RESULTS
There were no significant differences between the two groups as regards clinical characteristics or risk factors for coronary artery disease. During a 30-day follow up no major adverse cardiac events were observed (death, myocardial infarction, target vessel revascularisation). Multivariate logistic regression analysis showed no correlation between the anticoagulant used and the occurrence of major cardiac events in the two groups of patients (log odds ratio = -9.46, p = 0.89), after controlling for age, sex, administration of platelet glycoprotein IIb/IIIa inhibitors, number of coronary lesions, number of stents used, clinical picture and risk factors for coronary artery disease. As regards the development of haematoma in the groin, the only significant independent predictive factor for this was the coadministration of platelet glycoprotein IIb/IIIa inhibitors.


CONCLUSIONS
The use of enoxaparin in coronary angioplasty is safe, effective and allows faster removal of sheaths and mobilisation of the patient.