PMID- 10987586
OWN - NLM
STAT- MEDLINE
DCOM- 20000927
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 36
IP  - 3
DP  - 2000 Sep
TI  - Randomized trial of low molecular weight heparin (enoxaparin) versus 
      unfractionated heparin for unstable coronary artery disease: one-year results of 
      the ESSENCE Study. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave 
      Coronary Events.
PG  - 693-8
AB  - OBJECTIVES: We sought to determine whether the observed benefits of enoxaparin 
      were maintained beyond the early phase; a one-year follow-up survey was 
      undertaken for patients enrolled in the Efficacy and Safety of Subcutaneous 
      Enoxaparin in Non-Q wave Coronary Events (ESSENCE) study. BACKGROUND: We have 
      previously reported a significant benefit of low molecular weight as compared 
      with unfractionated heparin (UFH) in the 14- and 30-day incidence of a composite 
      end point of death, myocardial infarction (MI) or recurrent angina in patients 
      with unstable angina or non-Qwave MI. METHODS: The study recruited 3,171 patients 
      with recent-onset rest angina and underlying ischemic heart disease. All patients 
      received oral aspirin daily and were randomized to receive enoxaparin 
      subcutaneously every 12 h or UFH (intravenous bolus followed by continuous 
      infusion) in a double-blind, double-dummy fashion for a median of 2.6 days. 
      RESULTS: The incidence of the composite triple end point at one year was lower 
      among patients receiving enoxaparin as compared with those receiving UFH (32.0% 
      vs. 35.7%, p = 0.022), with a trend toward a lower incidence of the secondary 
      composite end point of death or MI (11.5% vs. 13.5%, p = 0.082). At one year, the 
      need for diagnostic catheterization and coronary revascularization was lower in 
      the enoxaparin group (55.8% vs. 59.4%, p = 0.036 and 35.9% vs. 41.2%, p = 0.002, 
      respectively). CONCLUSIONS: In patients with unstable angina or non-Qwave MI, 
      enoxaparin therapy significantly reduced the rates of recurrent ischemic events 
      and invasive diagnostic and therapeutic procedures in the short term with 
      sustained benefit at one year.
FAU - Goodman, S G
AU  - Goodman SG
AD  - Canadian Heart Research Center, Division of Cardiology, St. Michael's Hospital, 
      University of Toronto, Ontario, Canada. goodmans@smh.toronto.on.ca
FAU - Cohen, M
AU  - Cohen M
FAU - Bigonzi, F
AU  - Bigonzi F
FAU - Gurfinkel, E P
AU  - Gurfinkel EP
FAU - Radley, D R
AU  - Radley DR
FAU - Le Iouer, V
AU  - Le Iouer V
FAU - Fromell, G J
AU  - Fromell GJ
FAU - Demers, C
AU  - Demers C
FAU - Turpie, A G
AU  - Turpie AG
FAU - Califf, R M
AU  - Califf RM
FAU - Fox, K A
AU  - Fox KA
FAU - Langer, A
AU  - Langer A
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angina, Unstable/complications/*drug therapy
MH  - Cardiac Catheterization/statistics & numerical data
MH  - Double-Blind Method
MH  - Enoxaparin/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Follow-Up Studies
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Incidence
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/epidemiology/etiology/mortality
MH  - Myocardial Revascularization/statistics & numerical data
MH  - Secondary Prevention
EDAT- 2000/09/15 00:00
MHDA- 2000/09/30 00:00
CRDT- 2000/09/15 00:00
PHST- 2000/09/15 00:00 [pubmed]
PHST- 2000/09/30 00:00 [medline]
PHST- 2000/09/15 00:00 [entrez]
AID - S0735109700008081 [pii]
AID - 10.1016/s0735-1097(00)00808-1 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2000 Sep;36(3):693-8. doi: 10.1016/s0735-1097(00)00808-1.