The American Journal of Medicine
Volume 121, Issue 9 , Pages 805-810 , September 2008

Excess Heparin Dosing Among Fibrinolytic-treated Patients with ST-Segment Elevation Myocardial Infarction

  • Tracy Y. Wang, MD, MS

      Affiliations

    • Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
    • Corresponding Author InformationRequests for reprints should be addressed to Tracy Y. Wang, MD, MS, Duke Clinical Research Institute, 2400 Pratt Street, Room 0311, Terrace Level, Durham, NC 27705
    • ,
  • Anita Y. Chen, MS

      Affiliations

    • Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
    • ,
  • Karen P. Alexander, MD

      Affiliations

    • Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
    • ,
  • E. Magnus Ohman, MD

      Affiliations

    • Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
    • ,
  • W. Brian Gibler, MD

      Affiliations

    • University of Cincinnati College of Medicine, Cincinnati, Ohio
    • ,
  • Eric D. Peterson, MD, MPH

      Affiliations

    • Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
    • ,
  • Matthew T. Roe, MD, MHS

      Affiliations

    • Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina

References 

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  2. Mahaffey KW, Granger CB, Collins R, et al. Overview of randomized trials of intravenous heparin in patients with acute myocardial infarction treated with thrombolytic therapy. Am J Cardiol. 1996;77:551–556
  3. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction). J Am Coll Cardiol. 2004;44:E1–E211
  4. Van de Werf F, Ardissino D, Betriu A, et al. Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2003;24:28–66
  5. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986;42:121–130
  6. Moscucci M, Fox KA, Cannon CP, et al. Predictors of major bleeding in acute coronary syndromes: the Global Registry of Acute Coronary Events (GRACE). Eur Heart J. 2003;24:1815–1823
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  8. Granger CB, Hirsch J, Califf RM, et al. Activated partial thromboplastin time and outcome after thrombolytic therapy for acute myocardial infarction: results from the GUSTO-I trial. Circulation. 1996;93:870–878
  9. Giugliano RP, McCabe CH, Antman EM, et al. Thrombolysis in Myocardial Infarction (TIMI) Investigators Lower-dose heparin with fibrinolysis is associated with lower rates of intracranial hemorrhage. Am Heart J. 2001;141:742–750
  10. Alexander KP, Chen AY, Roe MT, et al. CRUSADE Investigators Excess dosing of antiplatelet and antithrombin agents in the treatment of non-ST-segment elevation acute coronary syndromes. JAMA. 2005;294:3108–3116
  11. Freedman JE, Becker RC, Adams JE, et al. American Heart Association Council on Clinical Cardiology Subcommittee on Acute Cardiac Care, Council on Cardiopulmonary and Critical Care, Council on Cardiovascular Nursing, and Council on Stroke (Medication errors in acute cardiac care: An American Heart Association scientific statement from the Council on Clinical Cardiology Subcommittee on Acute Cardiac Care, Council on Cardiopulmonary and Critical Care, Council on Cardiovascular Nursing, and Council on Stroke). Circulation. 2002;106:2623–2629
  12. Randomized trial of intravenous heparin versus recombinant hirudin for acute coronary syndromes (The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIa Investigators). Circulation. 1994;90:1631–1637
  13. Antman EM. Hirudin in acute myocardial infarction (Thrombolysis and Thrombin Inhibition in Myocardial Infarction (TIMI) 9B trial). Circulation. 1996;94:911–921
  14. Hochman JS, Wali AU, Gavrila D, et al. A new regimen for heparin use in acute coronary syndromes. Am Heart J. 1999;138(2 Pt 1):313–318
  15. Sabatine MS, Cannon CP, Gibson CM, et al. CLARITY-TIMI 28 Investigators Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med. 2005;352:1179–1189
  16. Chen ZM, Jiang LX, Chen YP, et al. COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366:1607–1621
  17. Antman EM, Morrow DA, McCabe CH, et al. ExTRACT-TIMI 25 Investigators Enoxaparin versus unfractionated heparin with fibrinolysis for ST-elevation myocardial infarction. N Engl J Med. 2006;354:1477–1488
  18. Yusuf S, Mehta SR, Chrolavicius S, et al. OASIS-6 Trial Group Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: the OASIS-6 randomized trial. JAMA. 2006;295:1519–1530

 CRUSADE was funded by Schering-Plough Corporation. Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership and PDL Pharmaceuticals provided additional funding support. Millennium Pharmaceuticals Inc, also partly funded this work.

PII: S0002-9343(08)00445-2

doi: 10.1016/j.amjmed.2008.04.023

The American Journal of Medicine
Volume 121, Issue 9 , Pages 805-810 , September 2008

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