RT Journal
A1 Quinlan DJ, Eikelboom JW
T1 LOw-molecular-weight heparin as an adjunct to thrombolysis in st elevation myocardial infarction
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2009
FD June 22
VO 169
IS 12
SP 1163
OP 1164
DO 10.1001/archinternmed.2009.126
UL http://dx.doi.org/10.1001/archinternmed.2009.126
AB 
The Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment (ExTRACT)–Thrombolysis in Myocardial Infarction (TIMI)-25 study1 demonstrated that the administration of enoxaparin sodium, 30 mg intravenously, followed by subcutaneous injections of 1 mg/kg twice daily (dose modified in patients 75 years or older), compared with intravenous unfractionated heparin (UFH), 60 U/kg bolus (maximum 4000 U), followed by 12 U/kg/h (initial maximum, 1000 U/h, and subsequently adjusted to maintain an activated partial thromboplastin time of 1.5-2.0 times the control value), reduced the risk of nonfatal reinfarction in patients with ST elevation myocardial infarction (STEMI) treated with thrombolysis. Because the ExTRACT-TIMI 25 study seems likely to be the last large trial evaluating the efficacy and safety of low-molecular-weight heparin (LMWH) in patients with STEMI, we added the results of this pivotal 20 000 patient trial to our meta-analysis published in 2005.2 Our updated literature search identified 1 additional study by Wang and colleagues3 published in 2006 involving 186 patients with STEMI who were randomized to receive parnaparin sodium or UFH; this study was also added to our meta-analysis.