(Circulation. 1999;100:1593-1601.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
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
From the Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital (E.M.A., C.H.M., E.B.) Boston, Mass; Fundacion Favaloro (E.P.G.), Buenos Aires, Argentina; McMaster University (A.G.G.T.), Hamilton, Ontario, Canada; Martini Hospital (P.J.L.M.B.), Groningen, Netherlands; Clinical Research Services (D.S.), Kelkheim, Germany; Hospital de la Santa Creu I Sant Pau (A.B.d.L.), Barcelona, Spain; Royal Brompton Hospital (K.F.), London, UK; Hopital Cardiologique (J.-M.L.), Lille, France; and Rhône-Poulenc Rorer (D.R., J.P.), Collegeville, Pa. Rhône-Poulenc Rorer manufactures Lovenox (enoxaparin).
Correspondence to Elliott M. Antman, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail eantman{at}rics.bwh.harvard.edu
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.
Key Words: angina • heparin • anticoagulants • coronary disease
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|
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|
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|
|
|
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|
|
|
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|
|
|
|
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|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 H. Pleym, V. Videm, A. Wahba, A. Asberg, T. Amundsen, L. Bjella, O. Dale, and R. Stenseth Heparin resistance and increased platelet activation in coronary surgery patients treated with enoxaparin preoperatively. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 933 - 940. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Part 8: Stabilization of the Patient With Acute Coronary Syndromes Circulation, December 13, 2005; 112(24_suppl): IV-89 - IV-110. [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 R. Aazami Initial Appraisal of Acute Coronary Syndromes Journal of Pharmacy Practice, October 1, 2005; 18(5): 377 - 393. [Abstract] [PDF]
|
|
|
|
 |
|
 H. U. Jones, J. B. Muhlestein, K. W. Jones, D. G. Renlund, T. L. Bair, T. J. Bunch, B. D. Horne, D. L. Lappe, J. L. Anderson, and D. B. Doty Early Postoperative Use of Unfractionated Heparin or Enoxaparin is Associated with Increased Surgical Re-Exploration for Bleeding Ann. Thorac. Surg., August 1, 2005; 80(2): 518 - 522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Sanchis, V Bodi, A Llacer, J Nunez, L Consuegra, M J Bosch, V Bertomeu, V Ruiz, and F J Chorro Risk stratification of patients with acute chest pain and normal troponin concentrations Heart, August 1, 2005; 91(8): 1013 - 1018. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
S. A. Spinler, P. Dobesh, C. Macie, and J. Douketis Dose Capping Enoxaparin Is Unjustified and Denies Patients With Acute Coronary Syndromes a Potentially Effective Treatment Chest, June 1, 2005; 127(6): 2288 - 2290. [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
Authors/Task Force Members, S. Silber, P. Albertsson, F. F. Aviles, P. G. Camici, A. Colombo, C. Hamm, E. Jorgensen, J. Marco, J.-E. Nordrehaug, et al. Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology Eur. Heart J., April 2, 2005; 26(8): 804 - 847. [Full Text] [PDF]
|
|
|
|
|
|
J. S Kalus and L. R Moser Evolving Role of Low-Molecular-Weight Heparins in ST-Elevation Myocardial Infarction Ann. Pharmacother., March 1, 2005; 39(3): 481 - 491. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Busch, I. Seitz, B. Steppich, S. Hess, R. Eckl, A. Schomig, and I. Ott Coagulation Factor Xa Stimulates Interleukin-8 Release in Endothelial Cells and Mononuclear Leukocytes: Implications in Acute Myocardial Infarction Arterioscler Thromb Vasc Biol, February 1, 2005; 25(2): 461 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Hanania, J-P Cambou, P Gueret, L Vaur, D Blanchard, J-M Lablanche, Y Boutalbi, R Humbert, P Clerson, N Genes, et al. Management and in-hospital outcome of patients with acute myocardial infarction admitted to intensive care units at the turn of the century: results from the French nationwide USIC 2000 registry Heart, December 1, 2004; 90(12): 1404 - 1410. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R Moser and J. S Kalus Role of Low-Molecular-Weight Heparin in Invasive Management of Non-ST-Elevation Acute Coronary Syndromes Ann. Pharmacother., December 1, 2004; 38(12): 2094 - 2104. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Bhatt, M. T. Roe, E. D. Peterson, Y. Li, A. Y. Chen, R. A. Harrington, A. B. Greenbaum, P. B. Berger, C. P. Cannon, D. J. Cohen, et al. Utilization of Early Invasive Management Strategies for High-Risk Patients With Non-ST-Segment Elevation Acute Coronary Syndromes: Results From the CRUSADE Quality Improvement Initiative JAMA, November 3, 2004; 292(17): 2096 - 2104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
M. Pedrini, F. Hartig, and C. Pechlaner Enoxaparin vs Unfractionated Heparin in Acute Coronary Syndrome JAMA, October 27, 2004; 292(16): 1952 - 1952. [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
B. S. Wiggins and S. Spinler Antiplatelet and Antithrombin Therapy for Early Management of Acute Coronary Syndromes Journal of Pharmacy Practice, October 1, 2004; 17(5): 347 - 369. [Abstract] [PDF]
|
|
|
|
|
|
J. M Ma, C. A Jackevicius, and E. Yeo Anti-Xa Monitoring of Enoxaparin for Acute Coronary Syndromes in Patients with Renal Disease Ann. Pharmacother., October 1, 2004; 38(10): 1576 - 1581. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. N. Levine, G. Raskob, R. J. Beyth, C. Kearon, and S. Schulman Hemorrhagic Complications of Anticoagulant Treatment: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest, September 1, 2004; 126(3_suppl): 287S - 310S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
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|
|
|
|
|
|
M. A. Blazing, J. A. de Lemos, H. D. White, K. A. A. Fox, F. W. A. Verheugt, D. Ardissino, P. M. DiBattiste, J. Palmisano, D. W. Bilheimer, S. M. Snapinn, et al. Safety and Efficacy of Enoxaparin vs Unfractionated Heparin in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Who Receive Tirofiban and Aspirin: A Randomized Controlled Trial JAMA, July 7, 2004; 292(1): 55 - 64. [Abstract] [Full Text] [PDF]
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|
|
|
|
|
J. L. Petersen, K. W. Mahaffey, V. Hasselblad, E. M. Antman, M. Cohen, S. G. Goodman, A. Langer, M. A. Blazing, A. Le-Moigne-Amrani, J. A. de Lemos, et al. Efficacy and Bleeding Complications Among Patients Randomized to Enoxaparin or Unfractionated Heparin for Antithrombin Therapy in Non-ST-Segment Elevation Acute Coronary Syndromes: A Systematic Overview JAMA, July 7, 2004; 292(1): 89 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. H Trichon and M. T Roe Acute coronary syndromes and diabetes mellitus Diabetes and Vascular Disease Research, May 1, 2004; 1(1): 23 - 32. [Abstract] [PDF]
|
|
|
|
|
|
C. Macie, L. Forbes, G. A. Foster, and J. D. Douketis Dosing Practices and Risk Factors for Bleeding in Patients Receiving Enoxaparin for the Treatment of an Acute Coronary Syndrome Chest, May 1, 2004; 125(5): 1616 - 1621. [Abstract] [Full Text] [PDF]
|
|
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|
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E. M Antman The re-emergence of anticoagulation in coronary disease Eur. Heart J. Suppl., April 1, 2004; 6(suppl_B): B2 - B8. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. I. Lev, D. Hasdai, E. Scapa, A. Tobar, A. Assali, J. Lahav, A. Battler, J. J. Badimon, and R. Kornowski Administration of eptifibatide to acute coronary syndrome patients receiving enoxaparin or unfractionated heparin: Effect on platelet function and thrombus formation J. Am. Coll. Cardiol., March 17, 2004; 43(6): 966 - 971. [Abstract] [Full Text] [PDF]
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|
|
|
|
|
K. Okamatsu, M. Takano, S. Sakai, F. Ishibashi, R. Uemura, T. Takano, and K. Mizuno Elevated Troponin T Levels and Lesion Characteristics in Non-ST-Elevation Acute Coronary Syndromes Circulation, February 3, 2004; 109(4): 465 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. R. Bijsterveld, R. J. G. Peters, S. A. Murphy, P. J. L. M. Bernink, J. G. P. Tijssen, M. Cohen, and TIMI 11B/ESSENCE Study Groups Recurrent cardiac ischemic events early after discontinuation of short-term heparin treatment in acute coronary syndromes: Results from the thrombolysis in myocardial infarction (TIMI) 11B and efficacy and safety of subcutaneous enoxaparin in Non-Q-Wave coronary events (ESSENCE) studies J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2083 - 2089. [Abstract] [Full Text] [PDF]
|
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|
 |
|
 J. Fareed, Q. Ma, M. Florian, J. Maddineni, O. Iqbal, D. A. Hoppensteadt, and R. Bick Unfractionated and Low-Molecular-Weight Heparins, Basic Mechanism of Action and Pharmacology Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2003; 7(4): 357 - 377. [Abstract] [PDF]
|
|
|
|
 |
|
 B. Medalion, G. Frenkel, P. Patachenko, E. Hauptman, L. Sasson, and A. Schachner Preoperative use of enoxaparin is not a risk factor for postoperative bleeding after coronary artery bypass surgery J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1875 - 1879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Rak and J. I. Weitz Heparin and Angiogenesis: Size Matters! Arterioscler Thromb Vasc Biol, November 1, 2003; 23(11): 1954 - 1955. [Full Text] [PDF]
|
|
|
|
|
|
E. Braunwald Application of Current Guidelines to the Management of Unstable Angina and Non-ST-Elevation Myocardial Infarction Circulation, October 21, 2003; 108(90161): III-28 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cohen, G. F. Gensini, F. Maritz, E. P. Gurfinkel, K. Huber, A. Timerman, M. Krzeminska-Pakula, N. Danchin, H. D. White, J. Santopinto, et al. The safety and efficacy of subcutaneous enoxaparin versus intravenous unfractionated heparin and tirofiban versus placebo in the treatment of acute ST-segment elevation myocardial infarction patients ineligible for reperfusion (TETAMI): A randomized trial J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1348 - 1356. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Dubois, A. Belmans, C. B. Granger, P. W. Armstrong, L. Wallentin, P. M. Fioretti, J. L. Lopez-Sendon, F. W. Verheugt, J. Meyer, F. Van de Werf, et al. Outcome of urgent and elective percutaneous coronary interventions after pharmacologic reperfusion with tenecteplase combined with unfractionated heparin, enoxaparin, or abciximab J. Am. Coll. Cardiol., October 1, 2003; 42(7): 1178 - 1185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. S. Aronow Review Article: Treatment of Unstable Angina Pectoris/Non-ST-Segment Elevation Myocardial Infarction in Elderly Patients J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2003; 58(10): M927 - 933. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Varo, J. A. de Lemos, P. Libby, D. A. Morrow, S. A. Murphy, R. Nuzzo, C. M. Gibson, C. P. Cannon, E. Braunwald, and U. Schonbeck Soluble CD40L: Risk Prediction After Acute Coronary Syndromes Circulation, September 2, 2003; 108(9): 1049 - 1052. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Prasad, V. Mathew, D. R Holmes Jr., and B. J Gersh Current management of non-ST-segment-elevation acute coronary syndrome: reconciling the results of randomized controlled trials Eur. Heart J., September 1, 2003; 24(17): 1544 - 1553. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E P Gurfinkel, G Bozovich, and B Mautner International comparison of mortality rates in patients with non-ST elevation acute coronary events Heart, September 1, 2003; 89(9): 1083 - 1084. [Full Text] [PDF]
|
|
|
|
|
|
N. R. Bijsterveld, A. H. Moons, J. C. M. Meijers, M. Levi, H. R. Buller, and R. J. G. Peters The impact on coagulation of an intravenous loading dose in addition to a subcutaneousregimen of low-molecular-weight heparinin the initial treatment of acute coronary syndromes J. Am. Coll. Cardiol., August 6, 2003; 42(3): 424 - 427. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. H. Kincaid, M. L. Monroe, D. L. Saliba, N. D. Kon, W. G. Byerly, and M. G. Reichert Effects of preoperative enoxaparin versus unfractionated heparin on bleeding indices in patients undergoing coronary artery bypass grafting Ann. Thorac. Surg., July 1, 2003; 76(1): 124 - 128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A Nutescu, R. K Lewis, J. M Finley, and G. T Schumock Hospital Guidelines for Use of Low-Molecular-Weight Heparins Ann. Pharmacother., July 1, 2003; 37(7): 1072 - 1081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Wallentin, L. Bergstrand, M. Dellborg, C. Fellenius, C. B Granger, B. Lindahl, L.-E. Lins, T. Nilsson, K. Pehrsson, A. Siegbahn, et al. Low molecular weight heparin (dalteparin) compared to unfractionated heparin as an adjunct to rt-PA (alteplase) for improvement of coronary artery patency in acute myocardial infarction--the ASSENT Plus study Eur. Heart J., May 2, 2003; 24(10): 897 - 908. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I P Casserly and E J Topol The primacy of clinical effectiveness for cost effectiveness analysis Heart, March 1, 2003; 89(3): 249 - 250. [Full Text] [PDF]
|
|
|
|
|
|
V. S. Monroe, R. A. Kerensky, E. Rivera, K. M. Smith, and C. J. Pepine Pharmacologic plaque passivation for the reduction of recurrent cardiac events in acute coronary syndromes J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 23S - 30S. [Abstract] [Full Text] [PDF]
|
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|
|
|
|
C. P. Cannon Small molecule glycoprotein IIb/IIIa receptor inhibitors as upstream therapy in acute coronary syndromes: Insights from the TACTICS TIMI-18 trial J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 43S - 48S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cohen The role of low-molecular-weight heparin in the management of acute coronary syndromes J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 55S - 61S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Sabatine and E. M. Antman The thrombolysis in myocardial infarction risk score in unstable angina/non-ST-segment elevation myocardial infarction J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 89S - 95S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. McKay "Ischemia-guided" versus "early invasive" strategies in the management of acute coronary syndrome/non-ST-segment elevation myocardial infarction: The interventionalist's perspective J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 96S - 102S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. E. Boden "Routine invasive" versus "selective invasive" approaches to non-ST-segment elevation acute coronary syndromes management in the post-stent/platelet inhibition era J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 113S - 122S. [Abstract] [Full Text] [PDF]
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