Light-weight heparin has heavy-weight results in heart attack treatment

DALLAS, Heart attack patients treated with the blood-thinner enoxaparin a low molecular weight heparin plus a clot dissolver were significantly less likely to die or have repeat heart attacks within 30 days compared to patients who received unfractionated heparin (UFH), according to a Rapid Track article in todays Circulation: Journal of the American Heart Association.

Patients in the study had what are known as ST-segment elevation myocardial infarctions, which are the most severe type of heart attack. We have very encouraging data but the evidence is not yet sufficient to say that enoxaparin should be standard treatment for severe heart attacks, says Elliott Antman, M.D., associate professor of medicine at Harvard Medical School and director of the coronary care unit of Brigham and Womens Hospital in Boston. However, the data suggest we should pursue a larger clinical trial.

Enoxaparin previously has been shown to be superior to unfractionated heparin (another blood thinner) for patients with milder heart attacks (non-ST segment elevation). It can be given as a simple injection, rather than the continuous infusion required with UFH, and it does not require frequent testing of the patients blood clotting status.

The researchers report their findings from the ENTIRE-TIMI 23 study. This international study involved 483 patients who presented with severe heart attacks at hospitals in the United States and Europe. Participants were randomly assigned either standard reperfusion with a full dose of the clot-dissolving drug tenecteplase (TNK) or combination therapy with abciximab and a half dose of TNK and either unfractionated heparin (UFH) or enoxaparin. Abciximab is a drug that helps keep blood platelets from sticking together to form clots.

The study was designed to evaluate enoxaparin as adjunctive treatment with various forms of reperfusion therapies (TNK, abciximab). To evaluate reperfusion (blood flow) researchers used the TIMI

Contact: Carole Bullock
American Heart Association

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