Non-ST-segment elevation acute coronary syndrome in patients with renal dysfunction: benefit of low-molecular-weight heparin alone or with glycoprotein IIb/IIIa inhibitors on outcomes. The Global Registry of Acute Coronary Events
Collet, Jean-Philippe Montalescot, Gilles Agnelli, Giancarlo Van de Werf, Frans Gurfinkel, Enrique P. López-Sendón, José Laufenberg, Christopher V. Klutman, Martin Gowda, Neelam Gulba, Dietrich C.
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Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants
Coronary Disease
Drug Therapy, Combination
Female
Hemorrhage
Heparin, Low-Molecular-Weight
Humans
Kidney Diseases
Male
Middle Aged
Platelet Glycoprotein GPIIb-IIIa Complex
Prospective Studies
Statistics as Topic
Syndrome
Treatment Outcome
Health Services Research
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Abstract
AIMS:
To determine whether low-molecular-weight heparin (LMWH)+glycoprotein (GP) IIb/IIIa inhibitors provide greater benefit than unfractionated heparin (UFH)+GP IIb/IIIa inhibitors, irrespective of renal status.
METHODS AND RESULTS:
Patients in the Global Registry of Acute Coronary Events (GRACE) were divided into three groups according to creatinine clearance (CrCl): normal renal function (CrCl >60 mL/min), moderate renal dysfunction (30
CONCLUSION:
In patients with renal dysfunction and non-ST-segment elevation ACS, bleeding complications are more frequent and outcomes appear worse in individuals treated with UFH compared with LMWH. Combination therapy with LMWH and GP IIb/IIIa inhibitors appears to be better tolerated than with UFH and GP IIb/IIIa inhibitors.
Source
Eur Heart J. 2005 Nov;26(21):2285-93. Epub 2005 Jun 2. Link to article on publisher's site