Key result
Fibrinolytic therapy combined with simpler adjunctive antithrombin therapy like tenecteplase and enoxaparin may be more efficacious and easier to use than regimens involving unfractionated heparin.
Why the study?
Does fibrinolytic therapy combined with low-molecular-weight heparin improve outcomes compared to unfractionated heparin in patients with acute ST-segment elevation myocardial infarction?
Does fibrinolytic therapy combined with low-molecular-weight heparin improve outcomes compared to unfractionated heparin in patients with acute ST-segment elevation myocardial infarction?
In STEMI patients without access to primary PCI, pharmacological reperfusion with fibrinolytics and low-molecular-weight heparin may be a simpler and more effective strategy than using unfractionated heparin.
One of the primary goals of physicians treating patients presenting to a hospital with acute ST-segment elevation myocardial infarction is to restore the flow of blood in the infarct-related artery as quickly as possible. Prompt and successful reperfusion limits the size of the myocardial infarction, reduces left ventricular dysfunction, and improves the patient's chance of survival. Approximately two thirds of patients with ST-segment elevation myocardial infarction do not present to a hospital capable of conducting urgent direct percutaneous coronary intervention or cardiac surgery when it is needed. They must receive pharmacological reperfusion therapy, a combination of fibrinolytic, antiplatelet, and anticoagulant drugs. Earlier and simpler administration of pharmacological reperfusion therapy could result in significantly improved outcomes. Fibrinolytic therapy, in combination with adjunctive antithrombin therapy that is simpler and quicker to administer (e.g., tenecteplase with enoxaparin), may be more efficacious and easier to use than regimens involving unfractionated heparin.
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Marc Cohen (2005) conducted a review in Acute ST-segment elevation myocardial infarction. Low-molecular-weight heparin (e.g., enoxaparin) with fibrinolytic therapy vs. Unfractionated heparin was evaluated. Fibrinolytic therapy combined with simpler adjunctive antithrombin therapy like tenecteplase and enoxaparin may be more efficacious and easier to use than regimens involving unfractionated heparin.
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