PMID- 11940541
OWN - NLM
STAT- MEDLINE
DCOM- 20020412
LR  - 20190623
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 105
IP  - 14
DP  - 2002 Apr 9
TI  - Enoxaparin as adjunctive antithrombin therapy for ST-elevation myocardial 
      infarction: results of the ENTIRE-Thrombolysis in Myocardial Infarction (TIMI) 23 
      Trial.
PG  - 1642-9
AB  - BACKGROUND: ENTIRE-TIMI 23 evaluated enoxaparin with full-dose tenecteplase (TNK) 
      and half-dose TNK plus abciximab. METHODS AND RESULTS: Patients (n=483) with 
      ST-elevation MI presenting <6 hours from symptom onset were randomized to 
      full-dose TNK and either unfractionated heparin (UFH) (bolus 60 U/kg; infusion 12 
      U/kg per hour) or enoxaparin (1.0 mg/kg subcutaneously every 12 hours+/-initial 
      30 mg intravenous bolus), or half-dose TNK plus abciximab and either UFH (bolus 
      40 U/kg; infusion 7 U/kg per hour) or enoxaparin (0.3 to 0.75 mg/kg 
      subcutaneously every 12 hours+/-initial intravenous bolus of 30 mg). With 
      full-dose TNK and UFH, the rate of TIMI 3 flow at 60 minutes was 52% and was 48% 
      to 51% with enoxaparin. Using combination therapy, the rate of TIMI 3 flow was 
      48% with UFH and 47% to 58% with enoxaparin. The rate of TIMI 3 flow among all 
      UFH patients was 50% and was 51% among enoxaparin patients. Through 30 days, 
      death/recurrent MI occurred in the full-dose TNK group in 15.9% of patients with 
      UFH and 4.4% with enoxaparin (P=0.005). In the combination therapy group, the 
      rates were 6.5% with UFH and 5.5% with enoxaparin. The rate of major hemorrhage 
      with full-dose TNK was 2.4% with UFH and 1.9% with enoxaparin; with combination 
      therapy, it was 5.2% using UFH and 8.5% with enoxaparin. CONCLUSIONS: Enoxaparin 
      is associated with similar TIMI 3 flow rates as UFH at an early time point while 
      exhibiting advantages over UFH with respect to ischemic events through 30 days. 
      These findings with enoxaparin are achieved with a similar risk of major 
      hemorrhage.
FAU - Antman, Elliott M
AU  - Antman EM
AD  - Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, 
      Mass, USA. eantman@rics.bwh.harvard.edu
FAU - Louwerenburg, Hans W
AU  - Louwerenburg HW
FAU - Baars, Hubert F
AU  - Baars HF
FAU - Wesdorp, Jan C L
AU  - Wesdorp JC
FAU - Hamer, Bas
AU  - Hamer B
FAU - Bassand, Jean-Pierre
AU  - Bassand JP
FAU - Bigonzi, Frederique
AU  - Bigonzi F
FAU - Pisapia, Ghislaine
AU  - Pisapia G
FAU - Gibson, C Michael
AU  - Gibson CM
FAU - Heidbuchel, Hein
AU  - Heidbuchel H
FAU - Braunwald, Eugene
AU  - Braunwald E
FAU - Van de Werf, Frans
AU  - Van de Werf F
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Immunoglobulin Fab Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - WGD229O42W (Tenecteplase)
RN  - X85G7936GV (Abciximab)
SB  - IM
EIN - Circulation 2002 Jun 11;105(23):2799
CIN - Circulation. 2002 Oct 29;106(18):e134. PMID: 12403679
MH  - Abciximab
MH  - Aged
MH  - Antibodies, Monoclonal/adverse effects/*therapeutic use
MH  - Anticoagulants/adverse effects/therapeutic use
MH  - Blood Flow Velocity/drug effects
MH  - Cohort Studies
MH  - Coronary Angiography/drug effects
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Electrocardiography/drug effects
MH  - Enoxaparin/adverse effects/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - Hemorrhage/etiology
MH  - Heparin/adverse effects/therapeutic use
MH  - Humans
MH  - Immunoglobulin Fab Fragments/adverse effects/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/*drug therapy/physiopathology
MH  - Platelet Aggregation Inhibitors/adverse effects/therapeutic use
MH  - Risk Assessment
MH  - Secondary Prevention
MH  - Survival Rate
MH  - Tenecteplase
MH  - Tissue Plasminogen Activator/adverse effects/*therapeutic use
MH  - Treatment Outcome
EDAT- 2002/04/10 10:00
MHDA- 2002/04/16 10:01
CRDT- 2002/04/10 10:00
PHST- 2002/04/10 10:00 [pubmed]
PHST- 2002/04/16 10:01 [medline]
PHST- 2002/04/10 10:00 [entrez]
AID - 10.1161/01.cir.0000013402.34759.46 [doi]
PST - ppublish
SO  - Circulation. 2002 Apr 9;105(14):1642-9. doi: 10.1161/01.cir.0000013402.34759.46.