PMID- 9779028
OWN - NLM
STAT- MEDLINE
DCOM- 19981022
LR  - 20220408
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 14 Suppl E
DP  - 1998 Aug
TI  - ESSENCE trial results: breaking new ground. Efficacy and Safety of Subcutaneous 
      Enoxaparin in Non-Q wave Coronary Events.
PG  - 15E-19E
AB  - OBJECTIVE: To demonstrate the superiority of enoxaparin compared with 
      unfractionated heparin (UFH) in preventing recurrent angina, myocardial 
      infarction (MI) and death in patients presenting with unstable angina or non-Q 
      wave MI. DESIGN: A prospective, randomized, double-blind multicentre trial. 
      SETTING: One hundred and seventy-six centers in 10 countries. PATIENTS: Three 
      thousand one hundred and seventy-one patients, male or nonpregnant females, 18 
      years of age or older, with unstable angina or non-Q wave MI. INTERVENTION: 
      Patients received either enoxaparin 1 mg/kg every 12 h subcutaneously plus an 
      intravenous placebo, or subcutaneous placebo injections and UFH as a continuous 
      intravenous infusion. All patients received 100 mg to 325 mg of acetylsalicylic 
      acid daily. Study treatment was administered for 48 h to 8 days. MAIN RESULTS: 
      The primary end-point (recurrent angina, MI or death) was significantly lower in 
      the enoxaparin group compared with the UFH group (16.6% versus 19.8%; P = 0.02) 
      after 14 days and remained significant after 30 days. The need for coronary 
      revascularization was significantly lower for patients assigned to enoxaparin 
      (27.0% versus 32.2%; P < 0.01) after 30 days. There was no difference in the risk 
      of serious hemorrhage between the two groups, but there was a significantly 
      higher incidence of minor hemorrhagic complications in the enoxaparin group 
      (11.9%) versus 7.2%; P < 0.01). CONCLUSIONS: Enoxaparin significantly reduced the 
      triple end-point of recurrent angina, MI and death at 14 days, with a sustained 
      effect at 30 days. There was no increase in the total number of hemorrhages; 
      however, a significant increase in the rate of minor hemorrhage was observed.
FAU - Demers, C
AU  - Demers C
AD  - Department of Hematology, Centre Hospitalier Affilie, Universite Laval, Quebec. 
      paradem@mediom.qc.ca
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Adult
MH  - Angina, Unstable/*drug therapy/prevention & control
MH  - Double-Blind Method
MH  - Enoxaparin/pharmacology/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/pharmacology/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/pharmacology/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/prevention & control
MH  - Prospective Studies
EDAT- 1998/10/21 00:00
MHDA- 1998/10/21 00:01
CRDT- 1998/10/21 00:00
PHST- 1998/10/21 00:00 [pubmed]
PHST- 1998/10/21 00:01 [medline]
PHST- 1998/10/21 00:00 [entrez]
PST - ppublish
SO  - Can J Cardiol. 1998 Aug;14 Suppl E:15E-19E.