An analysis of more than 6,000 patients treated for acute coronary syndromes (unstable angina/non-ST segment elevation myocardial infarction), indicates that those who received the blood thinner Lovenox ® (enoxaparin sodium) Injection prior to undergoing percutaneous coronary intervention (PCI) fared better than patients given unfractionated heparin. The analysis, based on the landmark ESSENCE and TIMI 11B* trials, was presented yesterday at the 50th Annual Scientific Session of the American College of Cardiology.
"Our findings are encouraging," said Keith A. A. Fox, professor of
cardiology at The University of Edinburgh, United Kingdom, and co-investigator
of the ESSENCE and TIMI 11B trials. "This data analysis showed a 40 percent
reduction in the risk of death and heart attack for patients who were given
the low-molecular-weight heparin enoxaparin and then underwent percutaneous
The study analyzed 6,068 patients from the ESSENCE and TIMI 11B trials for
death and heart attack at 43 days. In the ESSENCE and TIMI 11B trials, the
decision to proceed to revascularization was at the physician's discretion. A
total of 906 patients underwent PCI during their hospitalization; 471 of these
patients received coronary intervention within 12 hours following their
initial dose of either unfractionated heparin (UFH) or enoxaparin.
Enoxaparin-treated patients experienced a 40 percent risk reduction
(RR=0.60; 95 % CI 0.34 - 1.05) in death and heart attack following coronary
intervention as compared to UFH-treated patients. Specifically, 7.1 percent
of UFH-treated patients undergoing PCI during their hospitalization
experienced death or heart attack following the procedure, compared to
4.3 percent of enoxaparin-treated patients. Furthermore, there was a
17 percent risk reduction (RR=0.83; 95 % CI 0.67 - 1.04) in all death and
heart attack for enoxaparin-treated patients who did not undergo PCI, as
compared to UFH-treated patients (5.4 % enoxaparin vs. 6.5 % UFH).
"Low-molecular-weight heparin has proven superiority over unfractionated
heparin in the management of acute coronary syndromes," said Professor Fox.
"The important data from this analysis provides the foundation for further
studies to confirm the benefit of low-molecular-weight heparins before
* The ESSENCE (Efficacy and Safety of Subcutaneous Enoxaparin in
Non-Q-Wave Coronary Events) and TIMI 11B (Thrombolysis In Myocardial
Infarction) trials established the safety and efficacy of enoxaparin and
its superiority over unfractionated heparin in the treatment of unstable
angina and non-ST-segment elevation myocardial infarction.