PMID- 12208405
OWN - NLM
STAT- MEDLINE
DCOM- 20021002
LR  - 20220318
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 90
IP  - 5
DP  - 2002 Sep 1
TI  - Comparison of enoxaparin versus unfractionated heparin in patients with unstable 
      angina pectoris/non-ST-segment elevation acute myocardial infarction having 
      subsequent percutaneous coronary intervention.
PG  - 477-82
AB  - Patients with unstable angina or non-ST-segment elevation myocardial infarction 
      (MI) may undergo invasive revascularization procedures shortly after admission to 
      hospital or after a brief period of stabilization. In the Thrombolysis In 
      Myocardial Infarction (TIMI) 11B trial and Efficacy and Safety of Subcutaneous 
      Enoxaparin in Non-Q-Wave Coronary Events (ESSENCE) trial 1,326 patients underwent 
      percutaneous coronary intervention (PCI). A total of 924 patients underwent PCI 
      during the initial hospitalization period, and of these, 445 patients did so 
      while receiving treatment with unfractionated heparin (UFH) or the 
      low-molecular-weight heparin, enoxaparin. This analysis compared efficacy and 
      clinical events in the enoxaparin and UFH groups in patients who: (1) underwent 
      PCI while on treatment versus those who did not, and (2) underwent PCI in 
      hospital. We also compared those who did not undergo PCI. Treatment with 
      enoxaparin (1 mg/kg given as twice daily subcutaneous injections) was beneficial 
      and well tolerated in patients with unstable angina and non-ST-segment elevation 
      MI who underwent PCI. Compared with UFH, enoxaparin significantly reduced the 
      likelihood of clinical events (death and nonfatal MI after PCI) in patients who 
      underwent PCI after 1 year (p = 0.003 for in-hospital PCI; p = 0.005 for 
      on-treatment PCI), with a trend toward a reduced event rate at 43 days. In 
      addition, patients treated with enoxaparin who did not undergo PCI also showed a 
      reduction in the risk of death, nonfatal MI, and urgent revascularization when 
      compared with those treated with UFH (significant at 43 days, with a trend 
      persisting at 1 year). Study limitations were that PCI was nonrandomized, the 
      analysis was post hoc, and the sample size was relatively small. Nevertheless, in 
      the absence of large clinical trials, this study suggests that treatment with 
      enoxaparin was well tolerated, and exhibited a similar risk of major hemorrhage 
      to UFH in patients who underwent PCI.
FAU - Fox, Keith A A
AU  - Fox KA
AD  - Edinburgh Royal Infirmary, Edinburgh, United Kingdom. k.a.a.fox@ed.ac.uk
FAU - Antman, Elliott M
AU  - Antman EM
FAU - Cohen, Marc
AU  - Cohen M
FAU - Bigonzi, Frederique
AU  - Bigonzi F
CN  - ESSENCE/TIMI 11B Investigators
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Angina, Unstable/*complications/mortality/*therapy
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/*therapeutic use
MH  - Combined Modality Therapy
MH  - *Electrocardiography
MH  - Endpoint Determination
MH  - Enoxaparin/*therapeutic use
MH  - Follow-Up Studies
MH  - Hemorrhage/etiology
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Incidence
MH  - Myocardial Infarction/*complications/mortality/*therapy
MH  - Postoperative Complications/etiology
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2002/09/05 10:00
MHDA- 2002/10/03 04:00
CRDT- 2002/09/05 10:00
PHST- 2002/09/05 10:00 [pubmed]
PHST- 2002/10/03 04:00 [medline]
PHST- 2002/09/05 10:00 [entrez]
AID - S0002914902025171 [pii]
AID - 10.1016/s0002-9149(02)02517-1 [doi]
PST - ppublish
SO  - Am J Cardiol. 2002 Sep 1;90(5):477-82. doi: 10.1016/s0002-9149(02)02517-1.