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
Center for Outcomes Research
Medical Subject Headings
Acute Disease; 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
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
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.
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Citation: Eur Heart J. 2005 Nov;26(21):2285-93. Epub 2005 Jun 2. Link to article on publisher's site