• Guillermo Galeote, Raúl Moreno, Angel Sánchez-Recalde, Santiago Jiménez-Valero, Luís Calvo, Fernando Rivero, José F Gallegos, Estebán López de Sa, José A Sobrino, and José L López-Sendón.
• Unidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología. Hospital Universitario La Paz, Madrid. España. ggaleote.hulp@salud.madrid.org
• Med Intensiva. 2009 Jan 1; 33 (1): 1-7.

ObjectiveThe objective of this study is to compare the effectiveness of intravenous enoxaparin (ENX) and Non-fractionated Heparin (NFH) in primary angioplasty (PA) of acute myocardial infarction (PA-AMI).DesignA prospective, observational study.Patients And MethodsA total of 191 patients admitted at the hospital with the diagnosis of Acute Myocardial Infarction (AMI) and treated with primary angioplasty were included. ENX was used in 91 patients (47.6%) and NFH in 100 patients (52.4%). Choice of treatment was based on the operator's opinion. Patients with cardiogenic shock were excluded. The first group received an intravenous bolus of ENX (0.75-1 mg/Kg) and the second one NFH (70-100 u/Kg), depending on whether it was associated with abciximab or not. In-hospital follow-up was performed, evaluating mortality and bleeding complications of both treatments.ResultsIn-hospital mortality was 1.1% for the ENX group and 3.3% for NFH one. No significant differences were found in the number of bleeding complications with ENX (4.4%) and NFH (9.0%). There was one subacute thrombosis of stent for the ENX group and 3 thrombosis in the NFH-treated group. No significant differences were found in size of infarction measure with troponin I level (63.1 for ENX and 54.8 for the NFH) or in the left ventricle ejection fraction on hospital discharge (51% for ENX and 49.4% for the NFH).ConclusionsPrimary angioplasty can be safely sued with the intravenous administration of ENX, no significant differences being found between both treatments in mortality and bleeding complications.

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