Clinical efficacy and safety of enoxaparin in unselected Swiss patients undergoing primary or elective percutaneous coronary intervention: analysis of the RIVIERA study.

Background ― Appropriate antithrombotic therapy during percutaneous coronary intervention (PCI) reduces major cardiovascular events and bleeding complications.The objective of the present analysis of the multinational, prospective, observational Registry on IntraVenous anticoagulation In the Elective and primary Real world of Angioplasty (RIVIERA) was to prospectively evaluate in-hospital death, myocardial infarction (MI), major and minor bleeding, and angiographic complications of enoxaparin-guided primary or elective PCI. Methods ― In Switzerland, 255 consecutive patients from the Herz-Neuro-Zentrum Bodensee Kreuzlingen were enrolled in the RIVIERA study.The mean age of the patients was 64 years and 77% were men; 18% had primary PCI for acute STsegment elevation myocardial infarction.The mean dose of intravenous enoxaparin was 1mg/kg. Results ―The in-hospital mortality rate was 1.2%; MI occurred in 5.5% patients, and major and minor bleeding 0.8% and 2.7%, respectively.Angiographic complications occurred in 8.6% of patients, mainly coronary dissection (3.9%) and thrombus at the treated lesion site (1.6%). Conclusions ― In a real-world setting, the clinical efficacy and safety of intravenous enoxaparin during acute and elective PCI in a Swiss heart centre is comparable with the results of randomized controlled trials.