Enoxaparin Is Still Better than UFH When Combined with Eptifibatide

All patients with high-risk, non-ST-segment elevation acute coronary syndromes should receive enoxaparin instead of unfractionated heparin.

Enoxaparin has been demonstrated to be superior to unfractionated heparin (UFH) for non-ST-segment elevation acute coronary syndromes (ACSs) in 2 large trials, but these trials did not include a glycoprotein (GP) IIb/IIIa inhibitor. This randomized, multicenter, industry-supported study evaluated the safety and efficacy of the combined use of enoxaparin and the GP IIb/IIIa inhibitor eptifibatide in 746 patients with rest discomfort and ST-segment depression or elevated troponin levels.

All patients received aspirin and eptifibatide and were randomized to receive open-label enoxaparin or UFH for 24 hours. Outcomes were assessed by cardiologists who were blinded to treatment group. Approximately 30% of patients in both groups underwent percuta…

Reviewing Author

James M. Christenson, MD, FRCPC