Details

Autor(en) / Beteiligte

• Sabatine, Marc S., MD, MPH, FACC
• Morrow, David A., MD, MPH, FACC
• Dalby, Anthony, MD
• Pfisterer, Mathias, MD
• Duris, Tibor, MD
• Lopez-Sendon, Jose, MD, FACC
• Murphy, Sabina A., MPH
• Gao, Runlin, MD, FACC
• Antman, Elliott M., MD, FACC
• Braunwald, Eugene, MD, MACC

Titel

Efficacy and Safety of Enoxaparin Versus Unfractionated Heparin in Patients With ST-Segment Elevation Myocardial Infarction Also Treated With Clopidogrel

Ist Teil von

• Journal of the American College of Cardiology, 2007-06, Vol.49 (23), p.2256-2263

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2007

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Efficacy and Safety of Enoxaparin Versus Unfractionated Heparin in Patients With ST-Segment Elevation Myocardial Infarction Also Treated With Clopidogrel Marc S. Sabatine, David A. Morrow, Anthony Dalby, Mathias Pfisterer, Tibor Duris, Jose Lopez-Sendon, Sabina A. Murphy, Runlin Gao, Elliott M. Antman, Eugene Braunwald, for the EXTRACT–TIMI 25 Investigators In patients with ST-segment elevation myocardial infarction in the EXTRACT–TIMI 25 (Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment–Thrombolysis In Myocardial Infarction 25) trial, enoxaparin (ENOX) compared with unfractionated heparin (UFH) significantly reduced the rate of death, recurrent myocardial infarction, recurrent myocardial ischemia, or stroke, both in patients treated with clopidogrel (10.8% vs. 13.9%, adjusted odds ratio [ORadj ] 0.70, p = 0.013) and in patients not treated with clopidogrel (13.3% vs. 15.3%, ORadj 0.85, p = 0.003). The excess risk of TIMI major bleeding seen with ENOX versus UFH was numerically but not statistically significantly higher in patients treated with clopidogrel, and there was no significant excess of intracranial hemorrhage with ENOX over UFH regardless of clopidogrel use. Thus, ENOX offers a consistent net clinical benefit over UFH irrespective of concomitant treatment with clopidogrel.