PMID- 18217147
OWN - NLM
STAT- MEDLINE
DCOM- 20080221
LR  - 20141120
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 99
IP  - 1
DP  - 2008 Jan
TI  - Efficacy and safety of enoxaparin in unselected patients with ST-segment 
      elevation myocardial infarction.
PG  - 150-4
LID - 10.1160/TH07-07-0449 [doi]
AB  - In randomized clinical trials the low-molecular-weight heparin enoxaparin has 
      been shown to reduce ischemic complications in patients with acute ST elevation 
      myocardial infarction (STEMI) treated with fibrinolysis. Little is known about 
      the use and efficacy of enoxaparin in unselected patients with STEMI in clinical 
      practice. In a retrospective analysis of the prospective ACOS registry we 
      compared the outcomes of patients with STEMI treated with enoxaparin or 
      unfractionated heparin. A total of 6,299 patients with STEMI < 12 hours were 
      included in this analysis, 609 (10%) were treated with enoxaparin and 5,690 (90%) 
      with unfractionated heparin. In the multivariable propensity score analysis 
      enoxaparin was associated with a reduction in the combined endpoint of death and 
      non-fatal reinfarction in the entire group (odds ratio 0.59; 95% CI 0.43-0.80) 
      and the subgroups of patients treated without early reperfusion (odds ratio 0.65, 
      95% CI 0.43-0.97), fibrinolysis (odds ratio 0.64; 95% CI 0.33-1.26) and primary 
      percutaneous coronary intervention (odds ratio 0.33; 95% CI 0.15-0.72). There was 
      no significant increase in severe bleeding complications with enoxaparin (6.5% 
      versus 5.5%, p = 0.4). In clinical practice in unselected patients with STEMI 
      treated with or without early reperfusion therapy early treatment with enoxaparin 
      compared to unfractionated heparin is associated with a significant reduction of 
      the combined endpoint of inhospital death and reinfarction without a significant 
      increase in severe bleeding complications.
FAU - Zeymer, Uwe
AU  - Zeymer U
AD  - Herzzentrum Ludwigshafen, Medizinische Klinik B, Germany. Uwe.Zeymer@t-online.de
FAU - Gitt, Anselm
AU  - Gitt A
FAU - Junger, Claus
AU  - Junger C
FAU - Bauer, Timm
AU  - Bauer T
FAU - Heer, Tobias
AU  - Heer T
FAU - Koeth, Oliver
AU  - Koeth O
FAU - Wienbergen, Harm
AU  - Wienbergen H
FAU - Zahn, Ralf
AU  - Zahn R
FAU - Senges, Jochen
AU  - Senges J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Enoxaparin/adverse effects/*therapeutic use
MH  - Female
MH  - Germany
MH  - Hemorrhage/chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/mortality/therapy
MH  - Odds Ratio
MH  - Registries
MH  - Research Design
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Secondary Prevention
MH  - *Thrombolytic Therapy
MH  - Treatment Outcome
EDAT- 2008/01/25 09:00
MHDA- 2008/02/22 09:00
CRDT- 2008/01/25 09:00
PHST- 2008/01/25 09:00 [pubmed]
PHST- 2008/02/22 09:00 [medline]
PHST- 2008/01/25 09:00 [entrez]
AID - 08010150 [pii]
AID - 10.1160/TH07-07-0449 [doi]
PST - ppublish
SO  - Thromb Haemost. 2008 Jan;99(1):150-4. doi: 10.1160/TH07-07-0449.