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Enoxaparin and Unfractionated Heparin Compared

Last Updated: February 19, 2010.

Enoxaparin used in percutaneous coronary intervention reduces the risk of adverse cardiac outcomes compared to standard therapy with unfractionated heparin, according to a study in the February issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

FRIDAY, Feb. 19 (HealthDay News) -- Enoxaparin used in percutaneous coronary intervention (PCI) reduces the risk of adverse cardiac outcomes compared to standard therapy with unfractionated heparin (UFH), according to a study in the February issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

Gilles Montalescot, M.D., of the Pitié-Salpêtrière University Hospital in Paris, and colleagues conducted a substudy of the Facilitated INtervention with Enhanced Reperfusion Speed to Stop Events (FINESSE) trial, in which 2,452 patients with ST-segment elevation myocardial infarction were randomized to receive enoxaparin or UFH prior to PCI. Primary outcomes were incidence of nonintracranial Thrombolysis In Myocardial Infarction (TIMI) major and minor bleeding or intracranial hemorrhage by day seven, or hospital discharge (whichever came sooner). Patient outcomes were followed-up at 30 and 90 days post-PCI.

The researchers noted lower nonintracranial TIMI major bleeding with enoxaparin compared to UFH (2.6 versus 4.4 percent), while intracranial hemorrhage was similar with both drugs (0.27 versus 0.24 percent). The enoxaparin group also had reduced incidence of myocardial infarction, death, urgent revascularization, or refractory ischemia through 30 days post-PCI and lower all-cause mortality through 90 days.

"Montalescot et al are currently seeking to confirm the hypothesis raised by their FINESSE findings in a randomized, clinical outcome trial comparing IV enoxaparin (0.5 mg/kg) with UFH (50 to 70 U/kg with or 70 to 100 U/kg without glycoprotein IIb/IIIa inhibition)," writes the author of an accompanying editorial.

Several study authors reported financial relationships with, or being employed by, pharmaceutical companies.

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