The data from the TIMI 11B and ESSENCE studies were combined in a prospectively planned meta-analysis to provide statistically robust estimates of the effects of enoxaparin on specific end points.41,42 This analysis showed that the incidence of death or MI was significantly reduced in enoxaparin-treated patients from day 8 to day 43; similarly, the incidence of death, MI, or urgent revascularization was consistently about 20% lower in enoxaparin-treated patients than in patients treated with UFH from day 2 to day 43. The pooled incidence of major hemorrhagic complications during short-term treatment was 1.3% in the enoxaparin group and 1.1% in the UFH group (P = .35). The incidence of minor hemorrhages during the short-term phase was 10.0% and 4.3%, respectively (P<.001). A recently published meta-analysis by Eikelboom et al43 commented that the pooled LMWH trial data did not show a benefit of LMWH over UFH in unstable angina and non–ST segment elevation MI. The article highlighted that in the TIMI 11B and ESSENCE studies, at 72 hours (when the treatment durations of both UFH and enoxaparin were equal in most patients) there was no real benefit of enoxaparin over UFH in the "hard end point" of death and MI. Neither of these trials were powered to examine differences in efficacy at just 72 hours; to do so would have necessitated a much larger trial because of the low number of events at this early time point. It is notable, however, that when the data from TIMI 11B and ESSENCE are combined, there is a strong trend toward a benefit of enoxaparin for the composite end point of death and MI (enoxaparin, 1.9%, vs UFH, 2.5%; odds ratio, 0.77; 95% confidence interval, 0.56-1.01) and a significant benefit in the composite end point of death, MI, and recurrent angina requiring urgent revascularization (enoxaparin, 6.4%, vs UFH, 8.1%; odds ratio, 0.78; 95% confidence interval, 0.65-0.94).