PMID- 16442903
OWN - NLM
STAT- MEDLINE
DCOM- 20060210
LR  - 20181203
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 151
IP  - 2
DP  - 2006 Feb
TI  - Randomized evaluation of the efficacy of enoxaparin versus unfractionated heparin 
      in high-risk patients with non-ST-segment elevation acute coronary syndromes 
      receiving the glycoprotein IIb/IIIa inhibitor eptifibatide. Long-term results of 
      the Integrilin and Enoxaparin Randomized Assessment of Acute Coronary Syndrome 
      Treatment (INTERACT) trial.
PG  - 373-9
AB  - BACKGROUND: Patients with high-risk non-ST-segment elevation acute coronary 
      syndromes (NSTE ACS) benefit from the early administration of aspirin, a small 
      molecule glycoprotein IIb/IIIa inhibitor such as eptifibatide, and heparin. The 
      INTERACT trial demonstrated that in high-risk patients with ACS receiving aspirin 
      and eptifibatide, the use of enoxaparin compared with unfractionated heparin 
      (UFH) was associated with less bleeding, less early myocardial ischemia, and 
      improved 30-day outcomes. OBJECTIVE: The aim of our study was to determine 
      whether the short-term benefits of enoxaparin compared with UFH observed in 
      high-risk patients with NSTE ACS are maintained over a prolonged period of 
      follow-up. METHODS: Six hundred thirty-nine patients that were representative of 
      the total population of subjects in the INTERACT trial were followed up for a 
      median period of 2.5 years. RESULTS: In this group, the early benefit of 
      enoxaparin was maintained. The incidence of death or myocardial infarction at the 
      time of long-term follow-up was 39% lower in patients receiving enoxaparin 
      compared with those who received UFH (8.9% vs 14.7%, P = .024). There was no 
      difference in the frequency of cardiac catheterization in the groups receiving 
      either enoxaparin or UFH. CONCLUSIONS: The early treatment of high-risk patients 
      with NSTE ACS receiving aspirin and eptifibatide with enoxaparin is associated 
      with early outcome benefits that are sustained over a prolonged follow-up period. 
      This trial supports the concept that early treatment directed against platelet 
      and thrombin formation is associated with better short- and long-term outcomes.
FAU - Fitchett, David H
AU  - Fitchett DH
AD  - Canadian Heart Research Centre, St Michael's Hospital, University of Toronto, 
      Toronto, Ontario, Canada. fitchettd@smh.toronto.on.ca
FAU - Langer, Anatoly
AU  - Langer A
FAU - Armstrong, Paul W
AU  - Armstrong PW
FAU - Tan, Mary
AU  - Tan M
FAU - Mendelsohn, Aurora
AU  - Mendelsohn A
FAU - Goodman, Shaun G
AU  - Goodman SG
CN  - INTERACT Trial Long-Term Follow-Up Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Peptides)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 9005-49-6 (Heparin)
RN  - NA8320J834 (Eptifibatide)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - Evid Based Cardiovasc Med. 2006 Jun;10(2):113-5. PMID: 16753518
MH  - Angina, Unstable/*drug therapy
MH  - Anticoagulants/*therapeutic use
MH  - Aspirin/therapeutic use
MH  - Enoxaparin/*therapeutic use
MH  - Eptifibatide
MH  - Female
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/etiology/mortality
MH  - Peptides/therapeutic use
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Syndrome
EDAT- 2006/01/31 09:00
MHDA- 2006/02/14 09:00
CRDT- 2006/01/31 09:00
PHST- 2005/02/23 00:00 [received]
PHST- 2005/05/02 00:00 [accepted]
PHST- 2006/01/31 09:00 [pubmed]
PHST- 2006/02/14 09:00 [medline]
PHST- 2006/01/31 09:00 [entrez]
AID - S0002-8703(05)00490-4 [pii]
AID - 10.1016/j.ahj.2005.05.003 [doi]
PST - ppublish
SO  - Am Heart J. 2006 Feb;151(2):373-9. doi: 10.1016/j.ahj.2005.05.003.