The efficacy and safety of enoxaparin: a meta-analysis

The efficacy and safety of enoxaparin (ENOX) in percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) remains unaddressed. The primary endpoint evaluated was myocardial infarction (MI) or death. The secondary endpoint was defined as major bleeding complications. Studies comparing the differences in the efficacy and safety of ENOX versus unfractionated heparin (UFH) in PCI for the treatment of STEMI were evaluated. We presented the odds ratios for individual studies and performed heterogeneity, quality assessment, and publication bias analysis. This meta-analysis examined four randomized controlled trials (RCTs), and 5585 patients were included (2334 ENOX patients and 3251 UFH patients). The follow-up period of the endpoints was 30 or 90 days. Compared with UFH, ENOX significantly reduced the incidence of MI (OR, 0.74; P<0.01) and death (OR, 0.74; P<0.03), while there was no significant difference between the two treatments on major bleeding (OR,0.81; P=0.33). The findings from this meta-analysis suggested that the efficacy and safety of ENOX in the treatment of STEMI patients undergoing PCI were significantly better than patients treated with UFH. According to this meta-analysis, ENOX is the preferred anticoagulant for STEMI patients receiving PCI compared to UFH.