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The low-molecular-weight heparin dalteparin as adjuvant therapy in acute myocardial infarction: The ASSENT PLUS study
Univ Uppsala Hosp, Dept Cardiol, Uppsala, Sweden Univ Gothenburg, Sahlgrenska Univ Hosp Ostra, Dept Med, Gothenburg, Sweden Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden Linkoping Univ Hosp, Dept Cardiol, S-58185 Linkoping, Sweden.
Univ Uppsala Hosp, Dept Cardiol, Uppsala, Sweden Univ Gothenburg, Sahlgrenska Univ Hosp Ostra, Dept Med, Gothenburg, Sweden Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden Linkoping Univ Hosp, Dept Cardiol, S-58185 Linkoping, Sweden.
Univ Uppsala Hosp, Dept Cardiol, Uppsala, Sweden Univ Gothenburg, Sahlgrenska Univ Hosp Ostra, Dept Med, Gothenburg, Sweden Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden Linkoping Univ Hosp, Dept Cardiol, S-58185 Linkoping, Sweden.
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2001 (English)In: Clinical Cardiology, ISSN 0160-9289, Vol. 24, no 3, I12-I14 p.Article in journal (Refereed) Published
Abstract [en]

Rapid reperfusion of an infarct-related artery reduces the extent of myocardial damage and improves survival in acute myocardial infarction (AMI). Currently, anticoagulant treatment with unifractionated heparin (UFH) is used as adjuvant therapy to fibrinolytic treatment. The low-molecular-weight heparin (LMWH) dalteparin is at least as effective as UFH in unstable coronary artery disease. The ASSENT PLUS trial was carried out to evaluate whether dalteparin is as effective as UFH as an adjunct to recombinant tissue-plasminogen activator (rt-PA) and aspirin in obtaining patency and Thrombolysis in Myocardial Infarction (TIMI)-3 flow in patients with AMI. The primary assessment of this phase II trial was TIMI now, determined by coronary angiography. Patients with ST-elevation MI were randomized to receive aspirin and either rt-PA and UFH for 48 h, or rt-PA and dalteparin for 4 to 7 days. Evaluation was by TIMI flow after 4 to 7 days and clinical events (death, reinfarction, or revascularization) up to 30 days. There was a clear trend toward greater TIMI 3 flow with dalteparin compared with UFH. There was significantly less TIMI0-1 flow or thrombus in the dalteparin group. Bleeding rates were similar. The occurrence of reinfarction was reduced during dalteparin treatment. These findings suggest that dalteparin could be substituted for UFH as an adjunct to rt-PA/aspirin in the management of patients with AMI.

Place, publisher, year, edition, pages
2001. Vol. 24, no 3, I12-I14 p.
Keyword [en]
low-molecular-weight heparin, dalteparin, anticoagulant, ST-elevation myocardial infarction, TIMI flow, reinfarction, coronary artery, safety
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Medical and Health Sciences
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URN: urn:nbn:se:liu:diva-49348OAI: oai:DiVA.org:liu-49348DiVA: diva2:270244
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2013-09-11

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Swahn, Eva

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