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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 34-35页

作者： Wolak A. Ayzenberg Y. Cafri C. D. Zahger 王亭忠 Department of Cardiology So roka Medical Center Fac. Hlth. Sci. Ben Gurion Univ. N. Beer Sheva Israel

Background: Enoxaparin has gained wide acceptance in patients with acut e coron ary.sy.dromes. However, there is uncertainty.regarding management of patients wh o require coronary.intervention while on enoxaparin. Some phy.icians withhold th e morning dose of enoxaparin prior to coronary.intervention while others switch patients to unfractionated heparin. Both methods do not provide optimal anticoag ulation in the hours preceding intervention. There are no published controlled data to assess the safety.of coronary.intervention using enoxaparin alone in patients with acute coronary.sy.dromes. Methods: We p rospectively.compared enoxaparin to unfractionated heparin during coronary.angio graphy.and intervention. Sixty.four patients admitted to the coronary.care unit( CCU)were given enoxaparin twice daily. including on the morning of procedure. Co ronary.angiography.and intervention were performed without additional unfraction ated heparin. The control group comprised of 52 patients admitted to Internal Me dicine for an acute coronary.sy.drome. These were also given enoxaparin but the morning dose was withheld and unfractionated heparin was used during procedure. Results: Patients in both groups had similar baseline characteristics. No signif icant differences were observed between the two groups in procedural success rat e, complications or bleeding. One y.ar follow up showed similar rates of hospita lization and mortality. Conclusion: Enoxaparin seems to offer safe and effective procedural anticoagulation in patients undergoing percutaneous intervention for acute coronary.sy.dromes. Patients given enoxaparin can probably.have coronary.intervention without interruption of enoxaparin treatment and without additional procedural anticoagulation. These findings require confirmation in larger, rand omized trials.

关键词：依诺肝素急性冠脉综合征普通肝素冠脉介入治疗冠脉造影抗凝作用住院率随机试验

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