PMID- 20400762
OWN - NLM
STAT- MEDLINE
DCOM- 20110831
LR  - 20100902
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 31
IP  - 17
DP  - 2010 Sep
TI  - One-year outcomes after a strategy using enoxaparin vs. unfractionated heparin in 
      patients undergoing fibrinolysis for ST-segment elevation myocardial infarction: 
      1-year results of the ExTRACT-TIMI 25 trial.
PG  - 2097-102
LID - 10.1093/eurheartj/ehq098 [doi]
AB  - AIMS: To determine the impact of a strategy using enoxaparin for up to 8 days 
      compared with unfractionated heparin (UFH) for 48 h as an adjunct to fibrinolysis 
      for ST-segment elevation myocardial infarction (STEMI) on 1-year clinical 
      outcomes. METHODS AND RESULTS: Follow-up at 1 year (n = 20 275) was conducted by 
      telephone in the ExTRACT-TIMI 25 trial to ascertain the endpoints of death, MI, 
      and disabling stroke. The primary endpoint of death or non-fatal MI occurred in 
      1614 (15.8%) and 1732 (17.0%) of patients allocated to enoxaparin and UFH, 
      respectively [hazard ratio (HR) 0.92, 95% confidence interval (CI) 0.86-0.98, P = 
      0.01]. The enoxaparin strategy significantly reduced non-fatal MI at 1 year (5.7 
      vs. 6.8%, HR 0.82, 95% CI 0.73-0.92, P < 0.001). The risks of death (10.5 vs. 
      10.6%, HR 0.98, 95% CI 0.91-1.07) and disabling stroke (1.1 vs. 1.2%, HR 0.97, 
      95% CI 0.75-1.26) were not reduced. The composite of death, MI, or disabling 
      stroke favoured enoxaparin (HR 0.91, 95% CI 0.85-0.98, P = 0.007). CONCLUSION: 
      Compared with UFH for 48 h, a strategy using enoxaparin as an adjunct to 
      fibrinolysis resulted in a sustained reduction in death or MI at 1 year with no 
      additional benefit after 30 days. Mortality was not reduced at 1 year with the 
      enoxaparin strategy. The study was registered at ClinicalTrials.gov, NCT00077792.
FAU - Morrow, David A
AU  - Morrow DA
AD  - TIMI Study Group/Cardiovascular Division, Brigham and Women's Hospital, 75 
      Francis Street, Boston, MA 02115, USA. dmorrow@partners.org
FAU - Antman, Elliott M
AU  - Antman EM
FAU - Fox, Keith A A
AU  - Fox KA
FAU - White, Harvey D
AU  - White HD
FAU - Giugliano, Robert
AU  - Giugliano R
FAU - Murphy, Sabina A
AU  - Murphy SA
FAU - McCabe, Carolyn H
AU  - McCabe CH
FAU - Braunwald, Eugene
AU  - Braunwald E
CN  - ExTRACT-TIMI 25 Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT00077792
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20100417
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
SB  - IM
CIN - Eur Heart J. 2010 Sep;31(17):2077-9. PMID: 20525980
MH  - Adult
MH  - Aged
MH  - Double-Blind Method
MH  - Drug Therapy, Combination/methods
MH  - Enoxaparin/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Hemorrhage/chemically induced
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2010/04/20 06:00
MHDA- 2011/09/01 06:00
CRDT- 2010/04/20 06:00
PHST- 2010/04/20 06:00 [entrez]
PHST- 2010/04/20 06:00 [pubmed]
PHST- 2011/09/01 06:00 [medline]
AID - ehq098 [pii]
AID - 10.1093/eurheartj/ehq098 [doi]
PST - ppublish
SO  - Eur Heart J. 2010 Sep;31(17):2097-102. doi: 10.1093/eurheartj/ehq098. Epub 2010 
      Apr 17.