Clinical study on the different usage of enoxaparin in patients with acute myocardial infarction receiving reteplase therapy

Objective To evaluate the efficay and safety of different usage of enoxaparin in patients with acute myocardial infarction (AMI) receiving reteplase thrombolysis therapy.Methods Ninty patients were randomly divided into three groups by order of admission and each group were 30 cases.The patients of group A were treated with 30 mg enoxaparin by intravenous injection before thrombolysis,and received 1 mg/kg enoxaparin immediately by subcutaneous injection after thrombolysis.30 patients of group B received 1 mg/kg enoxaparin by subcutaneous injection before thrombolysis.The patients of group C were injected subcutaneous with 1 mg/kg enoxaparin immediately after thrombolysis. Then,all patients of three groups were injected subcutaneously with 1 mg/kg enoxaparin twice a day and repeated for 58 days.The rate of recanalization and the events of hemorrhage of post-thrombolysis was observed after 60 min and 90 min respectively.Results The rate of recanalization of 60 min after thrombolysis in group A,B and C was 83.3%,63.3% and 60.0% respectively,the rate of recanalization in group A was significantly higher than that of group B and group C respectively (P0.05),but there was no significant difference between group B and group C (P0.05).The rate of recanalization of 90 min after thrombolysis in group A,B and C was 90.0%,86.7% and 83.3% respectively,there was no significant difference among three groups (P0.05).No severe hemorrhages occurred in all three groups and the incidence of hemorrhagic events in group A,B,and C was 13.3%,10.0% and 10.0% respectively,there was no significant difference among three groups (P0.05).Conclusion Before thrombolytic therapy with reteplase,it can shorten the time of coronary recanalization and should not increase severe hemorrhage complications by intravenous injection of 30 mg enoxaparin.