CHAPTER 21 HEPARINIZING UNSTABLE ANGINA

Adding Heparin to Aspirin Reduces the Incidence of Myocardial Infarction and Death in Patients with Unstable Angina: A Meta-analysis

Oler A, Whooley MA, Oler J, et al. JAMA. 1996;276(10):811–815

BACKGROUND

Prospective studies had shown that 12% of patients hospitalized with unstable angina (UA) had an MI within 2 weeks with 1-year mortality ranging from 5% to 14% at the time of this study. Heparin had previously been shown to have benefit when used in patients with ST-elevation MI and during percutaneous coronary intervention, but prior randomized trials in the setting of UA had been unable to establish a definitive benefit of combination therapy regarding death or MI.

OBJECTIVES

To examine the effect on a composite endpoint of progression to MI or death in patients treated with heparin and aspirin compared to patients treated with aspirin alone.

METHODS

Meta-analysis of six studies conducted globally between the years 1966 and 1995.

Studies Included

Six randomized controlled trials, representing 1,353 patients, admitted with either UA or non–Q-wave MI.

Intervention Studied

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