CHAPTER 22 LOW-MOLECULAR-WEIGHT HEPARIN IN UNSTABLE ANGINA

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

Antman E, McCabe CH, Gurfinkel EP, et al. Circulation. 1999;100:1593–1601

BACKGROUND

At the time of this study, some work had shown that heparin, in addition to fibrinolytics, reduced mortality in acute coronary syndrom (ACS); however, this had been limited to studies looking at STEMI. Low-molecular-weight heparin (LMWH) had not been investigated in the treatment of ACS. This study tested the hypothesis that LMWH was superior to unfractioned heparin (UFH) in preventing death and cardiac ischemic events in unstable angina/non–Q-wave myocardial infarction, a recognized form of acute MI.

OBJECTIVES

To test the benefit of enoxaparin (LMWH) compared with the standard treatment of UFH in patients with unstable angina/non–Q-wave MI in reducing death and further cardiac ischemic events.

METHODS

Double-blinded randomized controlled trial in 200 centers across three countries.

Patients

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