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Non-ST-segment elevation acute coronary syndrome in patients with renal dysfunction: benefit of low-molecular-weight
Jean-Philippe Collet1, Gilles Montalescot, Giancarlo Agnelli
1Department of Cardiology, Centre Hôpital Pitié-Salpêtrière, Bureau 2-236, 47, Boulevard de l'Hôpital, 75013 Paris, France.
Aims:
To determine whether low-molecular-weight heparin (LMWH)+glycoprotein (GP) IIb/IIIa inhibitors provide greater benefit than unfractionated heparin (UFH)+GP IIb/IIIa inhibitors, irrespective of renal status.
Methods And Results:
Patients in the Global Registry of Acute Coronary Events (GRACE) were divided into three groups according to creatinine clearance (CrCl): normal renal function (CrCl >60 mL/min), moderate renal dysfunction (30
Conclusion:
In patients with renal dysfunction and non-ST-segment elevation ACS, bleeding complications are more frequent and outcomes appear worse in individuals treated with UFH compared with LMWH. Combination therapy with LMWH and GP IIb/IIIa inhibitors appears to be better tolerated than with UFH and GP IIb/IIIa inhibitors.
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