Linked Life Data

9092406

Source:http://linkedlifedata.com/resource/pubmed/id/9092406

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11 Suppl
pubmed:dateCreated
1997-4-10
pubmed:abstractText
Before the advent of thrombolysis, heparin was widely used in the acute phase of myocardial infarction. Its prescription was based on trials, often of criticable methodology, some of which showed a reduction in hospital mortality and others a reduction in the incidence of reinfarction, left ventricular thrombi or venous thromboembolism. A better understanding of physiopathology and the development of emergency methods of myocardial reperfusion (pharmacological or mechanical) showed that the real objective of management of acute myocardial infarction should be reopening of the occluded artery and the maintenance of its patency. Reocclusion which occurs in 20% of cases in associated with increased hospital morbidity and mortality. Heparin, which limits the paradoxial increase of thrombin after thrombolysis significantly decreases this risk. Two reference trials on the benefits of heparin in association with thrombolysis, GISSI-2 and ISIS-3, demonstrated a significant reduction in the 7 day mortality but no significant reduction in the 35 day mortality. The poor quality of the anticoagulation protocol, especially in patients receiving rtPA, explains these disappointing results. Thus, it has now been clearly established that heparin, even though it increases the number of bleeding complications should be associated early and at an appropriate dosage with all thrombolytic regimes or mechanical reperfusion methods used during acute myocardial infarction. Apart from the embolic complications or ventricular thrombosis, this anticoagulation only seems to be justified during the first 48 hours.
pubmed:language
fre
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0003-9683
pubmed:author
pubmed:issnType
Print
pubmed:volume
89
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1479-84
pubmed:dateRevised
2009-2-13
pubmed:meshHeading
pubmed:year
1996
pubmed:articleTitle
[Prescription of heparin in the acute phase of myocardial infarction: expected and observed benefits...].
pubmed:affiliation
Service de cardiologie, hôpital Cochin, Paris.
pubmed:publicationType
Journal Article, Comparative Study, English Abstract