Why the study?
Does enoxaparin reduce death and nonfatal reinfarction in patients undergoing primary percutaneous coronary intervention for acute ST segment elevation myocardial infarction compared to unfractionated heparin?
Does enoxaparin reduce death and nonfatal reinfarction in patients undergoing primary percutaneous coronary intervention for acute ST segment elevation myocardial infarction compared to unfractionated heparin?
Existing small studies and registries suggest enoxaparin may be superior to unfractionated heparin in primary PCI for STEMI, warranting a large randomized trial.
May support enoxaparin in primary PCI for STEMI; leaves open superiority over unfractionated heparin pending large randomized trials.
The inhibition of thrombin plays a key role as adjunct therapy in the management of patients with primary percutaneous coronary intervention for ST elevation myocardial infarction. Enoxaparin provides a more predictable and constant level of anticoagulation compared with the current standard unfractionated heparin. The available data from smaller studies and prospective registries suggest that enoxaparin is associated with a reduction in the rate of death and nonfatal reinfarction after primary percutaneous coronary intervention without an increase in bleeding complications. Thus, a large randomized trial is warranted to further evaluate the role of enoxaparin in these patients.
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Schwarz et al. (2008) studied this question.
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