Enoxaparin the preferred antithrombotic for MI

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Enoxaparin sodium [Lovenox, Clexane] is superior to unfractionated heparin (UFH) as adjunctive antithrombotic therapy in patients receiving fibrinolysis for ST-elevation myocardial infarction (MI), according to results of the ExTRACT-TIMI 25 trial presented at the 55th Annual Scientific Session of the American College of Cardiology (ACC) [Atlanta, Georgia, US; March 2006], and subsequently published online in the NEJM. Conducted in more than 20 000 patients at 674 centres in 48 countries, the ExTRACT-TIMI 25 trial demonstrated that, compared with UFH therapy for 48 hours, treatment with enoxaparin for the duration of the index hospitalisation reduced the relative risk of death or nonfatal MI at 30 days by 17%. Although treatment with enoxaparin increased the relative risk of major bleeding events at 30 days by 53%, three prespecified net-clinical-benefit composite outcomes showed significant advantages for therapy with enoxaparin over UFH.

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