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Low-Weight Heparin Reduces Bleeding in Coronary Surgery

Equal efficacy when compared with unfractionated heparin

THURSDAY, Dec. 13 (HealthDay News) -- Low-molecular-weight heparin (LMWH) significantly reduces major bleeding better than unfractionated heparin (UFH) in patients undergoing percutaneous coronary intervention without affecting the risk of ischemic complications such as death or heart attack, according to a report in the Dec. 10/24 issue of the Archives of Internal Medicine.

Raphaelle Dumaine, M.D., from Centre Hospitalier Universitaire Pitie-Salpetriere in Paris, France, and colleagues performed a meta-analysis of 13 published randomized trials comparing the safety and efficacy of UFH and LMWH as anticoagulants during percutaneous coronary intervention. Of the 7,318 patients, 57.4 percent received LMWH and 42.6 percent received UFH.

The researchers found that intravenous LMWH was associated with a significantly lower risk of major bleeding (odds ratio 0.57) and tended to reduce the risk of minor bleeding (odds ratio 0.75). The two heparins were similar regarding the risk of death, myocardial infarction and urgent revascularization.

"The use of intravenous LMWH during percutaneous coronary intervention is associated with a significant reduction in major bleeding events compared with UFH, without compromising outcomes on hard ischemic end points," Dumaine and colleagues conclude.

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