PMID- 10517729
OWN - NLM
STAT- MEDLINE
DCOM- 19991104
LR  - 20231024
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 100
IP  - 15
DP  - 1999 Oct 12
TI  - Enoxaparin prevents death and cardiac ischemic events in unstable 
      angina/non-Q-wave myocardial infarction. Results of the thrombolysis in 
      myocardial infarction (TIMI) 11B trial.
PG  - 1593-601
AB  - BACKGROUND: Low-molecular-weight heparins are attractive alternatives to 
      unfractionated heparin (UFH) for management of unstable angina/non-Q-wave 
      myocardial infarction (UA/NQMI). METHODS AND RESULTS: Patients (n=3910) with 
      UA/NQMI were randomized to intravenous UFH for >/=3 days followed by subcutaneous 
      placebo injections or uninterrupted antithrombin therapy with enoxaparin during 
      both the acute phase (initial 30 mg intravenous bolus followed by injections of 
      1.0 mg/kg every 12 hours) and outpatient phase (injections every 12 hours of 40 
      mg for patients weighing <65 kg and 60 mg for those weighing >/=65 kg). The 
      primary end point (death, myocardial infarction, or urgent revascularization) 
      occurred by 8 days in 14.5% of patients in the UFH group and 12.4% of patients in 
      the enoxaparin group (OR 0.83; 95% CI 0.69 to 1.00; P=0. 048) and by 43 days in 
      19.7% of the UFH group and 17.3% of the enoxaparin group (OR 0.85; 95% CI 0.72 to 
      1.00; P=0.048). During the first 72 hours and also throughout the entire initial 
      hospitalization, there was no difference in the rate of major hemorrhage in the 
      treatment groups. During the outpatient phase, major hemorrhage occurred in 1.5% 
      of the group treated with placebo and 2.9% of the group treated with enoxaparin 
      (P=0.021). CONCLUSIONS: Enoxaparin is superior to UFH for reducing a composite of 
      death and serious cardiac ischemic events during the acute management of UA/NQMI 
      patients without causing a significant increase in the rate of major hemorrhage. 
      No further relative decrease in events occurred with outpatient enoxaparin 
      treatment, but there was an increase in the rate of major hemorrhage.
FAU - Antman, E M
AU  - Antman EM
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts, USA. eantman@rics.bwh.harvard.edu
FAU - McCabe, C H
AU  - McCabe CH
FAU - Gurfinkel, E P
AU  - Gurfinkel EP
FAU - Turpie, A G
AU  - Turpie AG
FAU - Bernink, P J
AU  - Bernink PJ
FAU - Salein, D
AU  - Salein D
FAU - Bayes De Luna, A
AU  - Bayes De Luna A
FAU - Fox, K
AU  - Fox K
FAU - Lablanche, J M
AU  - Lablanche JM
FAU - Radley, D
AU  - Radley D
FAU - Premmereur, J
AU  - Premmereur J
FAU - Braunwald, E
AU  - Braunwald E
LA  - eng
PT  - Clinical Trial
PT  - Clinical Trial, Phase III
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Isoenzymes)
RN  - 9005-49-6 (Heparin)
RN  - EC 2.7.3.2 (Creatine Kinase)
SB  - IM
CIN - Circulation. 1999 Oct 12;100(15):1586-9. PMID: 10517727
MH  - Acute Disease
MH  - Aged
MH  - Angina, Unstable/complications/*drug therapy/surgery
MH  - Anticoagulants/administration & dosage/adverse effects/therapeutic use
MH  - Creatine Kinase/blood
MH  - Double-Blind Method
MH  - Electrocardiography
MH  - Emergencies
MH  - Enoxaparin/administration & dosage/adverse effects/*therapeutic use
MH  - Europe/epidemiology
MH  - Factor Xa Inhibitors
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Hemorrhage/chemically induced
MH  - Heparin/administration & dosage/adverse effects/*therapeutic use
MH  - Humans
MH  - Isoenzymes
MH  - Life Tables
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Myocardial Infarction/*drug therapy/epidemiology/etiology/prevention & 
      control/surgery
MH  - Myocardial Revascularization/statistics & numerical data
MH  - North America/epidemiology
MH  - Partial Thromboplastin Time
MH  - Recurrence
MH  - Safety
MH  - South America/epidemiology
MH  - *Thrombolytic Therapy/adverse effects
MH  - Treatment Outcome
EDAT- 1999/10/12 00:00
MHDA- 1999/10/12 00:01
CRDT- 1999/10/12 00:00
PHST- 1999/10/12 00:00 [pubmed]
PHST- 1999/10/12 00:01 [medline]
PHST- 1999/10/12 00:00 [entrez]
AID - 10.1161/01.cir.100.15.1593 [doi]
PST - ppublish
SO  - Circulation. 1999 Oct 12;100(15):1593-601. doi: 10.1161/01.cir.100.15.1593.