Enoxaparin versus tinzaparin in non-ST-segment elevation acute coronary syndromes: results of the enoxaparin versus tinzaparin (EVET) trial at 6 months (Journal article)

Katsouras, C./ Michalis, L. K./ Papamichael, N./ Adamidis, K./ Naka, K. K./ Nikas, D./ Goudevenos, J. A./ Sideris, D. A.


BACKGROUND: We have previously reported significant benefits of using enoxaparin, compared to tinzaparin, in the 7- and 30-day incidence of the composite triple end point of death, myocardial infarction (MI), or recurrent angina in patients with non-ST-segment elevation acute coronary syndromes (NSTACS). In the present study, we aimed to determine whether the observed benefits of enoxaparin were maintained beyond the early phase and report the results of the 6-m follow-up of patients in the EVET study. METHODS: We recruited 438 patients with NSTACS. All patients received oral aspirin and were randomized to also receive enoxaparin, 100 IU/kg subcutaneously twice daily (equivalent to 1 mg/kg twice daily; n = 220), or tinzaparin, 175 IU/kg subcutaneously once daily (n = 218), for up to 7 days. RESULTS: At 6 m, the incidence of the composite triple end point of death, MI, or recurrent angina was lower among patients receiving enoxaparin compared to those receiving tinzaparin (25.5% vs 44.0%, P < .001). A lower incidence of the secondary composite end point of death or MI was also found in the enoxaparin group compared to tinzaparin group (2.7% vs 6.9%, P = .046). The need for revascularization procedures was also lower in the enoxaparin group compared to tinzaparin group (23.2% vs 37.2%, P = .002). CONCLUSIONS: In patients with NSTACS, enoxaparin significantly reduced the rates of recurrent ischemic events and therapeutic procedures in the short term, with sustained benefit at 6 m compared to tinzaparin.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Acute Disease,Aged,Angina, Unstable/*drug therapy,Electrocardiography,Enoxaparin/*therapeutic use,Female,Follow-Up Studies,Heparin, Low-Molecular-Weight/*therapeutic use,Humans,Male,Middle Aged,Myocardial Infarction/*drug therapy/physiopathology,Syndrome,Time Factors
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/21934
ISSN: 1097-6744
Link: http://www.ncbi.nlm.nih.gov/pubmed/16169312
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