Low-molecular weight heparin Enoxaparin in the treatment of acute coronary syndromes without ST segment elevation

Objectives: We compared the incidence of adverse cardiac outcomes of enoxaparin vs unfractionated heparin in the management of ACS-NSTE. Background: Low-molecular-weight heparins are the potential new standard in the treatment of acute coronary syndromes without ST-segment elevation (ACS-NSTE). The benefit is addressed to significant diminution of the adverse clinical events - recurrent angina (RA), myocardial infarction (MI), heart failure (HF), cerebrovascular insult (ICV), coronary artery by-pass graft (CABG), percutaneous coronary intervention (PCI) and death. Methods: Sixty patients with ACS-NSTE were randomised to receive Enoxaparin 1 mg/kg body weight s.c twice daily (n=30) and unfractionated heparin (Heparin - "Biochemie" 25.000 IU/5 ml), according to Rashke nomo-gram (n=30). The end point were RA, MI, HF, ICV, CABG, PCI and death at day 180. The Kaplan-Meier estimation technique was used to compared the time to events for two treatments. A p<0.05 was considered to indicate significance. Results: For 180 days, RA, MI, HF, ICV and death were lower in the Enoxaparin vs UFH group (36.6 % vs 73.3 %, p=0.001), (30 % vs 53.3 %, p=0.05), (13.3 % vs 23.3 %, p=0.31), (3.3 % vs 10 %, p=0.29), (3.3 % vs 10 %, p=0.31), respectively. CABG were similar 13.3 % (p=0.96). PCI were performing in 33.3 % in UFH vs 90 % in LMWH (p=0.0001). Conclusion: The use of Enoxaparin in ACS-NSTE schows impressive decrease of incidence of ischemic events