PMID- 18078020
OWN - NLM
STAT- MEDLINE
DCOM- 20080111
LR  - 20211020
IS  - 1176-6344 (Print)
IS  - 1178-2048 (Electronic)
IS  - 1176-6344 (Linking)
VI  - 3
IP  - 5
DP  - 2007
TI  - Utilizing enoxaparin in the management of STEMI.
PG  - 691-700
AB  - The use of enoxaparin in conjunction with thrombolysis in ST-elevation acute 
      myocardial infarction (STEMI), has been recently investigated in several clinical 
      trials. In 8 published open-label studies including about 10,000 patients, in 
      which enoxaparin was compared to either placebo or unfractionated heparin (UFH), 
      a general superiority of enoxaparin on both reinfarction/recurrent angina and 
      patency of the infarct-related artery, was observed. Overall, bleeding rate with 
      enoxaparin was higher than with placebo and comparable to UFH, with the exception 
      of one study where pre-hospital administration induced a doubled incidence of 
      intracranial bleeding in patients older than 75 years. In a recent double-blind, 
      randomized, mega-trial including over 20,000 patients, the superior efficacy on 
      in-hospital and 30-day adverse cardiac events (namely reinfarction), and 
      comparable safety on intracranial bleedings of enoxaparin compared to UFH, was 
      definitively proven. In conclusion, initial intravenous bolus of enoxaparin 
      followed by twice daily subcutaneous administration for about 1 week should be 
      considered instead of intravenous UFH for the treatment of patients with STEMI 
      receiving thrombolysis. Along with its easiness of use, not requiring laboratory 
      monitoring, the subcutaneous administration of enoxaparin allows extended 
      antithrombotic treatment, while permitting early mobilization (and 
      rehabilitation) of patients.
FAU - Rubboli, Andrea
AU  - Rubboli A
AD  - Division of Cardiology, Maggiore Hospital, Bologna, Italy. 
      andrearubboli@libero.it
FAU - Capecchi, Alessandro
AU  - Capecchi A
FAU - Di Pasquale, Giuseppe
AU  - Di Pasquale G
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Vasc Health Risk Manag
JT  - Vascular health and risk management
JID - 101273479
RN  - 0 (Enoxaparin)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
SB  - IM
MH  - Clinical Trials as Topic
MH  - Enoxaparin/*therapeutic use
MH  - Hemorrhage/drug therapy
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*metabolism
MH  - Myocardial Infarction/*drug therapy/*enzymology
PMC - PMC2291313
EDAT- 2007/12/15 09:00
MHDA- 2008/01/12 09:00
PMCR- 2007/10/01
CRDT- 2007/12/15 09:00
PHST- 2007/12/15 09:00 [pubmed]
PHST- 2008/01/12 09:00 [medline]
PHST- 2007/12/15 09:00 [entrez]
PHST- 2007/10/01 00:00 [pmc-release]
PST - ppublish
SO  - Vasc Health Risk Manag. 2007;3(5):691-700.