In this industry-sponsored trial, patients with STEMI were randomized before PCI to get standard dosing unfractionated heparin or 0.5mg/kg of IV lovenox. There were no significant differences between the groups in the primary outcome (death, complication, procedure failure, or bleeding), but enoxaparin preformed better than heparin in the secondary outcome (death, recurrent ACS, urgent revasularization). Given the ease of administration and predictable dose-response, IV lovenox may be appealing for STEMI before PCI, although cost is higher (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.