Newer formulation of heparin improves outcomes for suspected heart attack patients

ORLANDO, FLA. A newer, more convenient formulation of the blood thinner heparin appears to improve outcomes with fewer complications -- when combined with a platelet receptor blocking drug and invasive management -- for patients who come to emergency rooms with a suspected heart attack.

Duke University Medical Center cardiologists said that the results of their analysis of more than 10,000 patients with unstable angina or non-ST-segment elevation myocardial infarction from the CRUSADE national quality improvement initiative confirms the findings of several large scale clinical trials that compared the efficacy and safety of the newer low molecular weight heparin (LMWH) enoxaparin to the older, intravenous "unfractionated" heparin. CRUSADE stands for "Can Rapid risk stratification of UnStable Angina patients suppress aDverse outcomes with Early implementation of the ACC/AHA guidelines."

The platelet receptor blocker used to treat patients in this analysis, called glycoprotein (GP) IIb/IIIa inhibitors, occupies receptors on blood platelets, blocking them from forming clots.

Kanwar Singh, M.D., cardiology fellow at the Duke Clinical Research Institute (DCRI), presented the results of the team's analysis today (Nov. 11, 2003) at the 76th annual scientific session of the American Heart Association.

When heart attack patients are rushed to the emergency room, physicians immediately try to restore blood flow to the heart, often by giving medications that dissolve clots or limit further clotting in the coronary arteries. Since no single drug has been totally effective in opening clogged arteries and keeping them open, researchers have tried different combinations of agents, in addition to early use of invasive procedures such as angioplasty.

"The message of our analysis is relatively simple - the low molecular weight heparins appear to be more effective than unfractionated heparin for patients with acute coronary syndromes treated wi

Contact: Richard Merritt
Duke University Medical Center

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