PMID- 15957976
OWN - NLM
STAT- MEDLINE
DCOM- 20060621
LR  - 20190917
IS  - 1744-7666 (Electronic)
IS  - 1465-6566 (Linking)
VI  - 6
IP  - 7
DP  - 2005 Jun
TI  - Clinical use of enoxaparin in the management of non-ST segment elevation acute 
      coronary syndromes.
PG  - 1241-51
AB  - Enoxaparin (Lovenox; Roule-Poulenc Rorer, Inc.), a low molecular weight heparin 
      (LMWH), is commonly used in the management of non-ST-segment elevation acute 
      coronary syndromes (NSTE ACS) based on clinical trial outcomes. It is one of a 
      group of glycosaminoglycan compounds that accelerate the inactivation of factor 
      Xa by inducing a conformational change in antithrombin. In contrast to 
      unfractionated heparin (UFH), LMWH have greater bioavailability, a more 
      predictable anticoagulant response, longer half-life and a higher proportion of 
      anti-factor Xa to anti-factor IIa activity. As a consequence, laboratory 
      monitoring of the anticoagulant effect is typically unnecessary. Antithrombin 
      therapy with LMWH or UFH has the highest-level recommendation (IA) in the 2002 
      professional guidelines for the management of unstable angina and 
      non-ST-elevation myocardial infarction, where enoxaparin has a IIA recommendation 
      over UFH unless early coronary artery bypass surgery is planned. In a recent 
      systematic overview of > 20,000 patients with NSTE ACS from six clinical trials, 
      including conservative and invasively managed patients, enoxaparin provided a 
      statistically significant reduction in 30-day death or nonfatal myocardial 
      infarction (MI) compared with UFH with no significant excess in transfusions, or 
      major bleeding. These data support the role of enoxaparin as an anti-coagulant in 
      patients with NSTE ACS.
FAU - Galla, John M
AU  - Galla JM
AD  - Duke Clinical Research Institute, Duke University Medical Center, 2400 Pratt 
      Street, Durham, NC 27715, USA.
FAU - Mahaffey, Kenneth W
AU  - Mahaffey KW
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - England
TA  - Expert Opin Pharmacother
JT  - Expert opinion on pharmacotherapy
JID - 100897346
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Disease
MH  - Angina, Unstable/drug therapy
MH  - Anticoagulants/pharmacokinetics/therapeutic use
MH  - Coronary Disease/*drug therapy
MH  - Enoxaparin/chemistry/pharmacokinetics/*therapeutic use
MH  - Heparin/analogs & derivatives/therapeutic use
MH  - Humans
MH  - Myocardial Infarction/drug therapy
MH  - Practice Guidelines as Topic
MH  - Randomized Controlled Trials as Topic
MH  - Syndrome
RF  - 42
EDAT- 2005/06/17 09:00
MHDA- 2006/06/22 09:00
CRDT- 2005/06/17 09:00
PHST- 2005/06/17 09:00 [pubmed]
PHST- 2006/06/22 09:00 [medline]
PHST- 2005/06/17 09:00 [entrez]
AID - 10.1517/14656566.6.7.1241 [doi]
PST - ppublish
SO  - Expert Opin Pharmacother. 2005 Jun;6(7):1241-51. doi: 10.1517/14656566.6.7.1241.