Nianzhong Tang1, Shaoping Chen2, Xiuying Shi2, Zhong Ye2, Xing Zheng2. 1. Department of Cardiovascular, No. 411 Hospital of PLA Shanghai 200081, China. 2. Department of Cardiovascular, Changhai Hospital of Second Military Medical University Shanghai 200433, China.
Abstract
OBJECTIVE: To explore the influence of enoxaparin on clinical events after percutaneous coronary intervention (PCI). METHODS: We recruited 400 patients that had undergone the percutaneous coronary intervention without complications in the Cardiology Department of Changhai Hospital consecutively from May 2011 to December 2012. The patients were randomly assigned to receive anticoagulation therapy (enoxaparin) or no anticoagulant. Patients were assessed for major adverse cardiac and cerebrovascular events (MACCEs) during hospitalization and at 1 and 12 months after PCI. RESULTS: There were no significant differences in the frequency of MACCEs between the two groups during hospitalization, at 1 month or 12 months post-PCI. During hospitalization, MACCEs occurred in 1.5% of the anticoagulation group versus 1.6% of the non-anticoagulation group (P>0.9). The groups had comparable rates of major bleeding (3.6% vs 2.1%, P=0.37), but minor bleeding was increased in the anticoagulation group (29.1% vs. 18.7%, P=0.016). At 1 month post-PCI, MACCEs occurred in 1.5% of the anticoagulation group and 2.6% of the non-anticoagulation group, (P=0.5), and at 12 months post-PCI, the rates were 5.6% vs. 6.2%, respectively (P=0.8). CONCLUSIONS: The frequency of MACCEs after PCI in the non-anticoagulation group was not significantly increased compared with that of the anticoagulation group. However, the rate of minor bleeding during hospitalization is significantly lower in non-anticoagulation group than that in anticoagulation group. The results suggest that routine anticoagulation therapy after PCI is not necessary for patients without procedure complications.
RCT Entities:
OBJECTIVE: To explore the influence of enoxaparin on clinical events after percutaneous coronary intervention (PCI). METHODS: We recruited 400 patients that had undergone the percutaneous coronary intervention without complications in the Cardiology Department of Changhai Hospital consecutively from May 2011 to December 2012. The patients were randomly assigned to receive anticoagulation therapy (enoxaparin) or no anticoagulant. Patients were assessed for major adverse cardiac and cerebrovascular events (MACCEs) during hospitalization and at 1 and 12 months after PCI. RESULTS: There were no significant differences in the frequency of MACCEs between the two groups during hospitalization, at 1 month or 12 months post-PCI. During hospitalization, MACCEs occurred in 1.5% of the anticoagulation group versus 1.6% of the non-anticoagulation group (P>0.9). The groups had comparable rates of major bleeding (3.6% vs 2.1%, P=0.37), but minor bleeding was increased in the anticoagulation group (29.1% vs. 18.7%, P=0.016). At 1 month post-PCI, MACCEs occurred in 1.5% of the anticoagulation group and 2.6% of the non-anticoagulation group, (P=0.5), and at 12 months post-PCI, the rates were 5.6% vs. 6.2%, respectively (P=0.8). CONCLUSIONS: The frequency of MACCEs after PCI in the non-anticoagulation group was not significantly increased compared with that of the anticoagulation group. However, the rate of minor bleeding during hospitalization is significantly lower in non-anticoagulation group than that in anticoagulation group. The results suggest that routine anticoagulation therapy after PCI is not necessary for patients without procedure complications.
Entities:
Keywords:
Percutaneous coronary intervention; bleeding; enoxaparin; major adverse cardiac and cerebrovascular events (MACCEs)
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