Enoxaparin in ACS

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Task Force Recommendations6 Rx studies(enoxaparin)ACS1 mg/kg SC BID 11 Rx studies(enoxaparin)PCIno add. LMWH Elective PCI 1° PCICATH LAB within 8 hours 0.5 mg/kg IV 0.5 mg/kg IV?5 non-Rx studies(enoxaparin)Definitive Evaluation of Enoxaparin AcrossCAD/ACS Spectrum > 50,000 patientsUA/NSTEMIMeta-analysisN=21,946patientsSTEMIMetaanalysisN>27,000patientstElective PCIMeta-analysisN>7,000patientsReduction in death/re-MI10% 22%Reduction in major bleeding43%Murphy SA, et al. Eur Heart J. 2007; Epub ahead of printDumaine R, et al. Arch Int Med (in press)
Clexane in ACS – My ApproachACSConservative StrategyInvasive StrategySTEMI NSTEMI • Prolonged procedure• Post CABG• No ACT availableNo Cathlab Glycoprotein• On Clexane in CCUWithin 3 hoursIIb/IIIaSK + fullFull lldoseClexane IVdose Clexane Clexane0.5 mg/kgConclusionsWhen making a a decision for propermanagement of patients with ACS weshould combine EBM with common sense.When using both,Clexane seems to be the bestchoice
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 and 22: NICE -3Objectiveso To assess the sa
Page 23: o DefinitionsAgendao Is UFH w/o dis
Page 27: Egyptian Guidelines for themanageme

Enoxaparin in ACS

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