July 6, 2004JAMA
Efficacy and Bleeding Complications Among Patients Randomized to Enoxaparin or Unfractionated Heparin for Antithrombin Therapy in Non–ST-Segment Elevation Acute Coronary Syndromes
Key result
Enoxaparin significantly reduced the combined end point of death or nonfatal MI at 30 days compared to unfractionated heparin in non-ST-segment elevation ACS (OR 0.91; 95% CI 0.83-0.99).
Why the study?
Does enoxaparin reduce the combined end point of death or nonfatal MI compared to unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes?
Population
21,946 patients with non-ST-segment elevation acute coronary syndromes pooled from 6 randomized controlled…
Comparison
Enoxaparin vs Unfractionated heparin
Design
Meta-analysis
Follow-up
30 days
Authors
Discussion
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Implication
Supports enoxaparin over unfractionated heparin in NSTE-ACS; confirms composite benefit without excess bleeding across 6 RCTs.
Study Design
Type
Meta-Analysis (n=21,946)
Multicenter
Yes
Structured PICO
Does enoxaparin reduce the combined end point of death or nonfatal MI compared to unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes?
P
Population
21,946 patients with non-ST-segment elevation acute coronary syndromes from 6 randomized controlled trials followed for up to 30 days.
I
Intervention
Enoxaparin
C
Comparator
Unfractionated heparin
O
Outcome
Combined end point of death or nonfatal MI at 30 dayscomposite
Main Result
Odds Ratio: 0.91 (95% CI 0.83–0.99)
Absolute Event Rate: 10.1% vs 11%
Number Needed to Treat: 107
In patients with non-ST-segment elevation acute coronary syndromes, enoxaparin is superior to unfractionated heparin in reducing the composite of death or nonfatal MI without significantly increasing major bleeding.
Cite This Study
Petersen et al. (2004) conducted a meta-analysis in non-ST-segment elevation acute coronary syndromes (n=21,946). Enoxaparin vs. Unfractionated heparin was evaluated on death or nonfatal MI at 30 days (OR 0.91, 95% CI 0.83-0.99). Enoxaparin significantly reduced the combined end point of death or nonfatal MI at 30 days compared to unfractionated heparin in non-ST-segment elevation ACS (OR 0.91; 95% CI 0.83-0.99).