PMID- 30069327
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 10
IP  - 6
DP  - 2018 Jun
TI  - Comparison of enoxaparin and unfractionated heparin in patients with 
      non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary 
      intervention: a systematic review and meta-analysis.
PG  - 3308-3318
LID - 10.21037/jtd.2018.05.113 [doi]
AB  - BACKGROUND: No randomized trial has been conducted to directly compare enoxaparin 
      with unfractionated heparin (UFH) in patients undergoing percutaneous coronary 
      intervention (PCI) for non-ST-segment elevation acute coronary syndrome 
      (NSTE-ACS). In an era where early invasive strategies are recommended in high 
      risk patients, the effect of enoxaparin and UFH needs to be re-evaluated. The 
      authors performed a meta-analysis to determine whether enoxaparin is superior to 
      UFH in patients with NSTE-ACS undergoing PCI. METHODS: The composite efficacy end 
      point included all-cause mortality and myocardial infarction (MI) in the hospital 
      or within 60 days. Major bleeding, as defined in the individual clinical trials 
      evaluated, was the main safety endpoint within the same time period. Pooled 
      estimates of the difference in outcome between enoxaparin and UFH were calculated 
      using fixed or random effects models. RESULTS: A total of 8,861 patients from 4 
      trials were included. In the pooled analysis, rates of death or MI were similar 
      in patients treated with enoxaparin and UFH [risk ratio (RR), 0.89, 95% 
      confidence interval (CI): 0.77-1.02, P=0.09; I(2) =50%]. Major bleeding was also 
      similar between enoxaparin and UFH (RR, 1.21, 95% CI: 0.94-1.56, P=0.15, 
      I(2)=39%). A subgroup analysis, including randomized trials only or trials with a 
      large sample size, and a leave-one-out sensitivity analysis, demonstrated similar 
      results with above, respectively. CONCLUSIONS: In patients undergoing PCI for 
      NSTE-ACS, rates for both death/MI and major bleeding were similar between 
      patients treated with enoxaparin and UFH.
FAU - He, Pengcheng
AU  - He P
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
AD  - Department of Cardiology, The Second People's Hospital of Nanhai District, 
      Guangdong General Hospital's Nanhai Hospital, Foshan 528251, China.
FAU - Liu, Yuanhui
AU  - Liu Y
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
FAU - Wei, Xuebiao
AU  - Wei X
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
FAU - Jiang, Lei
AU  - Jiang L
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
FAU - Guo, Wei
AU  - Guo W
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
FAU - Guo, Zhiqiang
AU  - Guo Z
AD  - Department of Cardiology, The Second People's Hospital of Nanhai District, 
      Guangdong General Hospital's Nanhai Hospital, Foshan 528251, China.
FAU - Lin, Chunying
AU  - Lin C
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
AD  - Department of Cardiology, The Second People's Hospital of Nanhai District, 
      Guangdong General Hospital's Nanhai Hospital, Foshan 528251, China.
FAU - Tan, Ning
AU  - Tan N
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
FAU - Chen, Jiyan
AU  - Chen J
AD  - Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong 
      Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General 
      Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC6051807
OTO - NOTNLM
OT  - Enoxaparin
OT  - acute coronary syndrome (ACS)
OT  - percutaneous coronary intervention (PCI)
OT  - unfractionated heparin (UFH)
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2018/08/03 06:00
MHDA- 2018/08/03 06:01
PMCR- 2018/06/01
CRDT- 2018/08/03 06:00
PHST- 2018/08/03 06:00 [entrez]
PHST- 2018/08/03 06:00 [pubmed]
PHST- 2018/08/03 06:01 [medline]
PHST- 2018/06/01 00:00 [pmc-release]
AID - jtd-10-06-3308 [pii]
AID - 10.21037/jtd.2018.05.113 [doi]
PST - ppublish
SO  - J Thorac Dis. 2018 Jun;10(6):3308-3318. doi: 10.21037/jtd.2018.05.113.