Enoxaparin in ACS

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NICE - 3151214Major Bleeding910Non-CABG Major Bleeding10.6630EPICNICE-3 4.5%4.13.8CAPTURENICE-3 1.9%21.51.1 0.85.3 5.12.41.4? ?EPILOG EPISTENT RESTORE PRISM+ IMPACT II PURSUIT3NICE -3Conclusionso Combination of enoxaparin plus GPIIb/IIIaantagonists does NOT result in major non-CABGbleeding.o Patients on combination therapy may safelyundergo PCI.o Enoxaparin could be prescribed followingthrombolytics (tenecteplase, SK) withoutincrease risk of ICH.
o DefinitionsAgendao Is UFH w/o disadvantageso High risk combination of anticoagulants inthe management of ACSo SKo Fibrinolyticso IIb/IIIa Inhibitorso When evidence meets real world practiceReasons for Quitting UFH in PCI1.Anticoagulation with UFH is unpredictable–In STEEPLE, only 20% of patients were in the“official” target range2.Frequent medical errors with UFH• LaPointe NM, Jollis JG. Arch InternMed. 2003;163:1461-1466.1461 14663.Clexane is safer, more effective & easier to3.Clexane is safer, more effective & easier touse
Page 1 and 2: Enoxaparin in ACSWhen evidence meet
Page 3 and 4: o DefinitionsAgendao Is UFH w/o dis
Page 5 and 6: Superiority ofEnoxaparin over UFHEv
Page 7 and 8: Coronary patency (TIMI flow 2 or 3)
Page 9 and 10: Enoxaparin versus UFH for STEMIOne
Page 11 and 12: No Increase in ICHents% Ev10UFHENOX
Page 13 and 14: New Data from ExTRACT-TIMI 251YEAR
Page 15 and 16: Net Clinical BenefitDeath/MI/Disabl
Page 17 and 18: Summary-23. Net clinical benefit si
Page 19 and 20: Enoxaparin and GP IIb/IIIa inhibito
Page 21: NICE -3Objectiveso To assess the sa
Page 25 and 26: Clexane in ACS - My ApproachACSCons
Page 27: Egyptian Guidelines for themanageme

Enoxaparin in ACS

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