Effect of Un-Fractionated Heparin and Low Molecular Weight Heparin on Hospital Mortality in Patients with Non ST Elevation Acute Coronary Syndrome (ACS)
Kitiporn Angkasuwapala MD*, Kasem Ratanasumawong MD**, Tachapong Ngarmukos MD***, Wirash Kehasukcharoen MD****, Watana Boonsom MD*****, Siriporn Kamsa-ard MPH******
Affiliation : * Division of Cardiology, Department of Medicine, Rajavithi Hospital, Bangkok ** Division of cardiology, Department of Medicine, Police General Hospital, Bangkok *** Ramathibodi Hospital, Mahidol University, Bangkok **** Chest Disease Institute, Nonthaburi ***** Department of Medicine, BMA Medical College and Vajira Hospital, Bangkok ****** Faculty of Public Health, Khon Kaen University, Khon Kaen
Background : The Thai ACS registry is a multi-center, prospective registration that describes the epidemiology,
management practices and in-hospital outcomes of patients with acute coronary syndromes.
Objective : Study the registry difference in hospital outcomes about cardiac death and length of stay between
low molecular weight heparin (LMWH) and un-fractionated heparin (UFH).
Materials and Methods : This is an observational descriptive study. The authors collected data from the database
of the Thai ACS registry.
Results : There were 233 of 3963 cases (5.9%) with cardiac death in the present study. Cardiac death in the
non-ST elevated myocardial infraction (NSTEMI) group was larger than in the UA group (7.6% vs. 2.4%,
p-value < 0.001). The heparin group had more cardiac death than the LMWH group (9.3% vs. 5.2%, p-value
< 0.001). NSTEMI with heparin treatment had more cardiac deaths than LMWH treatment (11.8% vs. 6.8%,
odd ratio 1.8). UA with heparin treatment had more cardiac deaths than LMWH treatment (4.0% vs. 2.0%, odd
ratio 2.0). NSTEMI had a longer length of stay than UA (56.9% vs. 44.7%, p-value = 0.001). The heparin
group had a longer stay than LMWH (58.8% vs. 51.7%, p-value < 0.001).
Conclusion : Low molecular weight heparin had benefit over un-fractionated heparin in reduction of hospital
mortality and length of stay in both unstable angina and non-ST elevation myocardial infarction.
Keywords : NSTEMI, UA, LMWH,UFH, ACS, Myocardial infraction, Unstable angina, Low molecular weight heparin, Un-fractionated heparin, Heparin, Acute coronary syndromes, Non-ST elevation myocardial infraction
