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The effect of dalteparin versus unfractionated heparin on the levels of troponin I and creatine kinase isoenzyme MB in elective percutaneous coronary intervention: a multicenter study

Zhang, Guangminga; Cui, Weia; Li, Yongjuna; Gao, Xiaolie; Wei, Qingminf; Cao, Xuebing; Xiao, Wenliangd; Jiang, Pingb; Lyu, Xinhuc; Liu, Fana; Gu, Guoqianga; Liu, Jinminga

doi: 10.1097/MCA.0000000000000128
Original Research

Background The aim of this study was to investigate the safety and efficacy of dalteparin during an elective percutaneous coronary intervention (PCI) procedure in a large cohort.

Materials and methods In this prospective, randomized, open-label design study, 733 patients undergoing elective PCI were divided into an unfractionated heparin group (group 1, 323 patients) or a dalteparin group (group 2, 410 patients). Blood samples were collected before and 18–24 h after the PCI procedure to determine the serum levels of cardiac troponin I (cTnI) and creatine kinase isoenzyme MB. Major adverse cardiac events (MACEs) and bleeding events during hospitalization were also recorded. Patients with an increased level of serum cTnI before PCI were excluded from the study.

Results After PCI, the cTnI values were greater than three times the upper limit of normal in 43 cases (13.3%) in group 1 and 52 cases (12.7%) in group 2, without a statistically significant difference between the two groups (P=0.801). An increased creatine kinase isoenzyme MB level of greater than two times the upper limit of normal was found in 10 cases (3.1%) in group 1 and 12 cases (2.9%) in group 2, without a statistically significant difference between the two groups (P=0.894). Postoperative bleeding was observed in nine patients (2.8%) in group 1 and six patients (1.5%) in group 2. Postoperative MACEs were observed in two patients (0.6%) in group 1 and two patients (0.5%) in group 2. There were no significant differences between the two groups with respect to bleeding events or MACEs.

Conclusion Our study showed that dalteparin might be as effective and safe as unfractionated heparin for anticoagulation during elective PCI.

aDepartment of Cardiology, The Second Hospital of Hebei Medical University

bDepartment of Cardiology, The Third Hospital of Shijiazhuang City

cDepartment of Cardiology, People’s Hospital of Shijiazhuang City

dDepartment of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang

eDepartment of Cardiology, General Hospital of Huabei Oilfield, Renqiu

fDepartment of Cardiology, People’s Hospital of Xingtai City, Xingtai

gDepartment of Cardiology, 252 Hospital of PLA, Baoding, China

Correspondence to Wei Cui, MD, Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China Tel: +86 311 66002115; fax: +86 311 66002115; e-mail: cuiwei@medmail.com.cn

This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Received February 24, 2014

Received in revised form April 15, 2014

Accepted April 17, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins