BACKGROUND: Clinical studies have clearly revealed that low-molecular-weight heparins (LMWHs) are an effective alternative to unfractionated heparin in the therapy of acute coronary syndrome (ACS); however, data on the comparison of different LMWHs are sparse. AIM: To compare the inhibition of coagulation factor Xa by enoxaparin and nadroparin in the therapy of ACS. METHODS:Thirty-eight consecutive patients with ACS were randomly assigned to enoxaparin (group E, n=18) or nadroparin (group N, n=20) in the recommended dose. Anti-Xa activity was measured 3 h after administering the first dose of LMWH. RESULTS: Baseline demographics (age, sex) and clinical (type of ACS, pain-to-door time, elevation of troponin, percutaneous coronary intervention performed, smoking status, and history of diabetes, hypertension and hyperlipoproteinemia) characteristics were similar in both groups. Anti-Xa activity was significantly higher in group E than in group N (0.65+/-0.05 U/mL versus 0.30+/-0.03 U/mL; P<0.001). Moreover, the therapeutic target (0.5 U/mL to 0.8 U/mL) was achieved in 66.7% of patients in group E; on the other hand, effective therapy was observed in 10.0% of patients in group N (P<0.001). CONCLUSIONS: The results of the present study demonstrate a highly significant difference in anti-Xa activity of enoxaparin and nadroparin in their recommended dosing regimens, in the therapy of ACS 3 h after subcutaneous administration; the anticoagulant effect of enoxaparin was markedly stronger than that of nadroparin.
RCT Entities:
BACKGROUND: Clinical studies have clearly revealed that low-molecular-weight heparins (LMWHs) are an effective alternative to unfractionated heparin in the therapy of acute coronary syndrome (ACS); however, data on the comparison of different LMWHs are sparse. AIM: To compare the inhibition of coagulation factor Xa by enoxaparin and nadroparin in the therapy of ACS. METHODS: Thirty-eight consecutive patients with ACS were randomly assigned to enoxaparin (group E, n=18) or nadroparin (group N, n=20) in the recommended dose. Anti-Xa activity was measured 3 h after administering the first dose of LMWH. RESULTS: Baseline demographics (age, sex) and clinical (type of ACS, pain-to-door time, elevation of troponin, percutaneous coronary intervention performed, smoking status, and history of diabetes, hypertension and hyperlipoproteinemia) characteristics were similar in both groups. Anti-Xa activity was significantly higher in group E than in group N (0.65+/-0.05 U/mL versus 0.30+/-0.03 U/mL; P<0.001). Moreover, the therapeutic target (0.5 U/mL to 0.8 U/mL) was achieved in 66.7% of patients in group E; on the other hand, effective therapy was observed in 10.0% of patients in group N (P<0.001). CONCLUSIONS: The results of the present study demonstrate a highly significant difference in anti-Xa activity of enoxaparin and nadroparin in their recommended dosing regimens, in the therapy of ACS 3 h after subcutaneous administration; the anticoagulant effect of enoxaparin was markedly stronger than that of nadroparin.
Authors: W B Batchelor; K W Mahaffey; P B Berger; E Deutsch; S Meier; V Hasselblad; E T Fry; P S Teirstein; A M Ross; C A Binanay; J P Zidar Journal: J Am Coll Cardiol Date: 2001-11-15 Impact factor: 24.094
Authors: A M Ross; P Molhoek; C Lundergan; M Knudtson; Y Draoui; L Regalado; V Le Louer; F Bigonzi; W Schwartz; E de Jong; K Coyne Journal: Circulation Date: 2001-08-07 Impact factor: 29.690
Authors: John L Petersen; Kenneth W Mahaffey; Vic Hasselblad; Elliott M Antman; Marc Cohen; Shaun G Goodman; Anatoly Langer; Michael A Blazing; Anne Le-Moigne-Amrani; James A de Lemos; Christopher C Nessel; Robert A Harrington; James J Ferguson; Eugene Braunwald; Robert M Califf Journal: JAMA Date: 2004-07-07 Impact factor: 56.272
Authors: James J Ferguson; Robert M Califf; Elliott M Antman; Marc Cohen; Cindy L Grines; Shaun Goodman; Dean J Kereiakes; Anatoly Langer; Kenneth W Mahaffey; Christopher C Nessel; Paul W Armstrong; Alvaro Avezum; Phil Aylward; Richard C Becker; Luigi Biasucci; Steven Borzak; Jacques Col; Marty J Frey; Ed Fry; Dietrich C Gulba; Sema Guneri; Enrique Gurfinkel; Robert Harrington; Judith S Hochman; Neal S Kleiman; Martin B Leon; Jose Luis Lopez-Sendon; Carl J Pepine; Witold Ruzyllo; Steven R Steinhubl; Paul S Teirstein; Luis Toro-Figueroa; Harvey White Journal: JAMA Date: 2004-07-07 Impact factor: 56.272
Authors: Sigmund Silber; Per Albertsson; Francisco F Avilés; Paolo G Camici; Antonio Colombo; Christian Hamm; Erik Jørgensen; Jean Marco; Jan-Erik Nordrehaug; Witold Ruzyllo; Philip Urban; Gregg W Stone; William Wijns Journal: Eur Heart J Date: 2005-03-15 Impact factor: 29.983