Effectiveness and safety of unfractionated heparin with sequential enoxaparin in patients with complex coronary artery disease undergoing elective percutaneous coronary intervention

Hou Xiaolin; Huang Ji; Li Zhizhong; Wang Su; Tao Ying; Yin Chengqian; Gao Yulong

doi:10.3760/cma.j.issn.1673-4777.2017.08.005

Abstract：Objective To explore the effectiveness and safety of unfractionated heparin (UFH) with sequential enoxaparin in patients with complex coronary artery disease undergoing elective percutaneous coronary intervention(ePCI).Methods A total of 805 patients who were diagnosed with complex coronary artery disease undergoing ePCI from April 2015 to May 2016 in Beijing Anzhen Hospital,Capital Medical University were randomly assigned to have UFH with sequential enoxaparin(observational group,n =405) and routine UFH (control group,n =400).Patients in both groups were administered 3 000 U UFH before coronary angiography;the observation group was administered enoxaparin 0.75-1.00 mg/kg and the control group was added UFH to a total dose of 100 U/kg before ePCI.Blood coagulation indexes,troponin level,operation success rate,types of complex coronary artery lesion,stent numbers and size were analyzed.Incidences of major adverse cardiac events(MACE) and thrombolysis in myocardial infarction (TIMI) major bleeding were analyzed.Results There were no significant differences of activated partial thromboplastin time before and 24 h after administration,activated coagulation time 1 h after administration and postoperative troponin level between groups(P ＞ 0.05).The success rate of operation was 99.0％ (396/400) in control group and 98.8％ (400/405) in observation group,there was no significant difference between groups(P ＞ 0.05).There were no significant differences between groups in types of complex coronary artery lesion,the number of lesions,the number,length and diameter of stents(P ＞0.05).The 30 d and 1 year MACE rates showed no significant differences between groups(P ＞ 0.05).No TIMI major bleeding occurred in both groups.Conclusion UFH with sequential enoxaparin may be as effective and safe as the standard UFH anticoagulant therapy in treatment of ePCI for complex coronary artery disease.