022: Compared efficacy and safety of unfractionned heparins versus low-molecular-weight heparins in STEMI patients

Background Low-molecular-weight heparinshave recently been introduced in the management of ST elevationmyocardial infarction (STEMI) patients but evidence remains poor among specific populations particularly elderly and patients with renal dysfunction. Objective to compare the outcome (mortality and hemorrhage) between patients treated with unfractionned heparin (UFH) versus low-molecular-weight heparins(LMWHs) in the whole population and among elderly and renal dysfunction patients. Methods Patients admitted for STEMI between January 1995 and November 2011 were retrospectively enrolled in the MIRAMI (MonastIR Acute Myocardial Infarction) registry. We compared the outcome (mortality and hemorrhage) between patients who received UFH versus LMWHs in the global MIRAMI population, then among elderly (aged over 75 years) and renal dysfunction patients (defined by a creatinin level >130 μmol/l). Resultats UFH was more often used when thrombolysis was adopted as reperfusion therapy(80.6% vs 68.6% when primary angioplasty is adopted, p Conclusion In the MIRAMI registry, LMWHs seemed to be at least as safe and effective as UFH in STEMI patients, even in elderly or renal dysfunction population.