![]() This study provides a practical and fairly easy to use method by which practitioners can risk stratify patients presenting with acute coronary syndromes. ![]() The greatest benefit of low molecular weight heparin compared to unfractionated heparin occurred in patients with multiple risk variables, particularly those with four or more of the seven high-risk markers. unfractionated heparin in patients at various risk levels. ![]() The analysis also compared the relative benefit of low molecular weight heparin (enoxaparin) vs. The rate of the composite endpoint varied from as low as 4.7% in patients with no or one marker to a level of 40.9% in those with six or seven of the markers noted. Patients with no or one variable had a mortality rate of 1.2%, those with four variables had 2.5% and those with six or seven markers had a mortality rate of 6.5%. By aggregating patients with 0 to as many as 7 markers, a corresponding stepwise increase in the overall risk of mortality, myocardial infarction and urgent revascularization was observed. The seven independent predictor variables of the combined endpoints included age > 65 years, three or more risk factors for coronary heart disease, known prior coronary stenosis of at least 50%, ST-segment elevation or depression on presenting electrocardiography, two or more anginal episodes in the preceding 24 hours, aspirin use within a week of presentation and elevated serum markers of myocardial injury.
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