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Back To Vidyya Prior To Coronary Interventions, Injection With Lovenox ® May Be Of Potential Benefit


Results Come From An Analysis Of The TIMI And ESSENCE Trials



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 coronary intervention."

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 coronary intervention."

* 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.


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Editor: Susan K. Boyer, RN
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