Intravenous enoxaparin versus unfractionated heparin in unselected patients undergoing percutaneous coronary interventions: the Zurich enoxaparin versus unfractionated heparin in PCI study (ZEUS).

Aims: To evaluate the efficacy and safety of intravenous enoxaparin as an alternative to unfractionated heparin (UFH) as antithrombotic therapy in unselected patients undergoing percutaneous coronary intervention (PCI).

Methods And Results: Eight hundred and seventy-six (876) consecutive eligible patients undergoing PCI were prospectively randomised to either intravenous enoxaparin 0.75 mg/kg or dose-adjusted UFH in this open-label study that was prematurely stopped due to slow recruitment.

Interaction of vitamin K antagonists with heparin affect monitoring by activated clotting times.

Background: Unfractionated heparin is recommended during atrial fibrillation (AF) ablation to achieve activated clotting time (ACT) above 250-300 s to prevent clot. Many patients on therapeutic international normalised ratio (INR) undergo AF ablation procedures; however, it is unknown whether they require less heparin to achieve similar ACT levels.

Methods: During AF ablation, the ACT was measured before and 10 min after administration of i.

Long-term survival and functional outcome of unselected patients undergoing percutaneous coronary intervention for acute myocardial infarction.

Background: Percutaneous coronary intervention (PCI) is the most effective reperfusion modality in patients with acute myocardial infarction (MI). Data concerning long-term survival and functional outcome are sparse.

Methods: One thousand consecutive patients treated by emergency PCI were systematically ana-lysed in a single-centre registry.

Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock.

Background: Inflammatory response is an important feature of acute coronary syndromes and myocardial infarction (MI). The prognostic value of proinflammatory cytokines in patients with acute MI complicated by cardiogenic shock is unknown.

Methods And Results: In 41 patients admitted with acute MI (age 60 +/- 11 years, six females, 19 Killip class IV) serial plasma concentration of tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6) and interleukin 1 receptor antagonist (IL-1Ra) were measured.

Profound drug-induced thrombocytopenia before urgent cardiopulmonary bypass.

A patient with acute coronary syndrome scheduled for urgent coronary artery bypass grafting developed a profound thrombocytopenia during therapy with intravenous heparin and the glycoprotein IIb/IIIa inhibitor tirofiban. Heparin-induced thrombocytopenia and all other possible aetiologies were unlikely and the low platelet count had to be attributed to tirofiban. Anticoagulation during cardiopulmonary bypass was successfully managed with standard heparin.