Enoxaparin Prevents Death and Cardiac Ischemic Events in Unstable Angina/Non–Q-Wave Myocardial Infarction
Why the study?
Does enoxaparin reduce the composite of death, myocardial infarction, or urgent revascularization in patients with unstable angina/non-Q-wave myocardial infarction compared to unfractionated heparin?
Population
3,910 patients with unstable angina/non-Q-wave myocardial infarction (UA/NQMI)
Comparison
Enoxaparin vs Intravenous unfractionated heparin for ≥3 days…
Design
RCT, randomized
Follow-up
43 days
Authors
Discussion
Loading...
Member takes
Implication
Supports enoxaparin over UFH for acute UA/NQMI management; confirms LMWH benefit on ischemic events.
Structured PICO
Does enoxaparin reduce the composite of death, myocardial infarction, or urgent revascularization in patients with unstable angina/non-Q-wave myocardial infarction compared to unfractionated heparin?
P
Population
3,910 patients with unstable angina/non-Q-wave myocardial infarction (UA/NQMI)
I
Intervention
Enoxaparin (initial 30 mg IV bolus followed by 1.0 mg/kg SC every 12 hours during acute phase, then 40 mg or 60 mg SC every 12 hours based on weight during outpatient phase)
C
Comparator
Intravenous unfractionated heparin (UFH) for ≥3 days followed by subcutaneous placebo injections
O
Outcome
Composite of death, myocardial infarction, or urgent revascularization by 8 days and 43 dayscomposite
Enoxaparin is superior to UFH for reducing death and ischemic events during acute management of UA/NQMI, but outpatient continuation increases major bleeding without additional benefit.
Cite This Study
Antman et al. (1999) studied this question.