Is Enoxaparin Better Than Unfractionated Heparin for PCI After Fibrinolysis?

Results of a subgroup analysis from ExTRACT-TIMI 25 were encouraging.

In the manufacturer-funded ExTRACT-TIMI 25 trial, enoxaparin administered for 7 days was a better adjunct to fibrinolysis than was unfractionated heparin (UFH) administered for 48 hours (Journal Watch Cardiology Apr 6 2006). In this prospective subanalysis, investigators analyzed results in 4676 patients who subsequently underwent percutaneous coronary intervention within 30 days.

Patients who received enoxaparin required PCI slightly less frequently (23% vs. 24%, P=0.027) and slightly later (122 hours vs. 109 hours, P=0.006) than patients who received UFH, owing to a delay in recurrence of ischemia or MI. The primary endpoint of death or MI by 30 days after fibrinolysis occurred in a smaller percentage of PCI patients who received enoxapari…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI