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Is there a role for low-molecular-weight heparin (LMWH) in the management of ST-segment-elevation MI (STEMI)? To find out, researchers conducted a double-blind, placebo-controlled trial in which 15,570 STEMI patients in India and China (mean age, 59) were randomized to receive either the LMWH reviparin (dose-adjusted for body weight) or placebo for 1 week, in addition to usual post-STEMI care. All subjects presented within 12 hours of symptom onset, 73% underwent thrombolysis, and 6% underwent primary PCI. Reviparin's manufacturer provided the study drug.
Incidence of the primary composite endpoint (death, reinfarction, or stroke) was significantly lower among reviparin recipients than among placebo recipients at 7 days (9.6% vs. 11.0%) and …