|Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) 11B trial.|
|PMID: 10517729 Owner: NLM Status: MEDLINE|
|BACKGROUND: Low-molecular-weight heparins are attractive alternatives to unfractionated heparin (UFH) for management of unstable angina/non-Q-wave myocardial infarction (UA/NQMI). METHODS AND RESULTS: Patients (n=3910) with UA/NQMI were randomized to intravenous UFH for >/=3 days followed by subcutaneous placebo injections or uninterrupted antithrombin therapy with enoxaparin during both the acute phase (initial 30 mg intravenous bolus followed by injections of 1.0 mg/kg every 12 hours) and outpatient phase (injections every 12 hours of 40 mg for patients weighing <65 kg and 60 mg for those weighing >/=65 kg). The primary end point (death, myocardial infarction, or urgent revascularization) occurred by 8 days in 14.5% of patients in the UFH group and 12.4% of patients in the enoxaparin group (OR 0.83; 95% CI 0.69 to 1.00; P=0. 048) and by 43 days in 19.7% of the UFH group and 17.3% of the enoxaparin group (OR 0.85; 95% CI 0.72 to 1.00; P=0.048). During the first 72 hours and also throughout the entire initial hospitalization, there was no difference in the rate of major hemorrhage in the treatment groups. During the outpatient phase, major hemorrhage occurred in 1.5% of the group treated with placebo and 2.9% of the group treated with enoxaparin (P=0.021). CONCLUSIONS: Enoxaparin is superior to UFH for reducing a composite of death and serious cardiac ischemic events during the acute management of UA/NQMI patients without causing a significant increase in the rate of major hemorrhage. No further relative decrease in events occurred with outpatient enoxaparin treatment, but there was an increase in the rate of major hemorrhage.|
|E M Antman; C H McCabe; E P Gurfinkel; A G Turpie; P J Bernink; D Salein; A Bayes De Luna; K Fox; J M Lablanche; D Radley; J Premmereur; E Braunwald|
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|Type: Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't|
|Title: Circulation Volume: 100 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 1999 Oct|
|Created Date: 1999-11-04 Completed Date: 1999-11-04 Revised Date: 2006-11-15|
Medline Journal Info:
|Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES|
|Languages: eng Pagination: 1593-601 Citation Subset: AIM; IM|
|Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Angina, Unstable / complications, drug therapy*, surgery
Anticoagulants / administration & dosage, adverse effects, therapeutic use
Creatine Kinase / blood
Enoxaparin / administration & dosage, adverse effects, therapeutic use*
Europe / epidemiology
Factor Xa / antagonists & inhibitors
Fibrinolytic Agents / administration & dosage, adverse effects, therapeutic use*
Hemorrhage / chemically induced
Heparin / administration & dosage, adverse effects, therapeutic use*
Myocardial Infarction / drug therapy*, epidemiology, etiology, prevention & control, surgery
Myocardial Revascularization / statistics & numerical data
North America / epidemiology
Partial Thromboplastin Time
South America / epidemiology
Thrombolytic Therapy* / adverse effects
|0/Anticoagulants; 0/Enoxaparin; 0/Fibrinolytic Agents; 0/Isoenzymes; 9005-49-6/Heparin; EC 18.104.22.168/Creatine Kinase; EC 22.214.171.124/Factor Xa|
|Circulation. 1999 Oct 12;100(15):1586-9
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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