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  Vol. 169 No. 12, June 22, 2009 TABLE OF CONTENTS
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Low-Molecular-Weight Heparin as an Adjunct to Thrombolysis in ST Elevation Myocardial Infarction

Daniel J. Quinlan, MBBS; John W. Eikelboom, MBBS, MSc, FRACP

Arch Intern Med. 2009;169(12):1163-1164.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment (ExTRACT)–Thrombolysis in Myocardial Infarction (TIMI)-25 study1 demonstrated that the administration of enoxaparin sodium, 30 mg intravenously, followed by subcutaneous injections of 1 mg/kg twice daily (dose modified in patients 75 years or older), compared with intravenous unfractionated heparin (UFH), 60 U/kg bolus (maximum 4000 U), followed by 12 U/kg/h (initial maximum, 1000 U/h, and subsequently adjusted to maintain an activated partial thromboplastin time of 1.5-2.0 times the control value), reduced the risk of nonfatal reinfarction in patients with ST elevation myocardial infarction (STEMI) treated with thrombolysis. Because the ExTRACT-TIMI 25 study seems likely to be the last large trial evaluating the efficacy and safety of low-molecular-weight heparin (LMWH) in patients with STEMI, we added the results of this pivotal 20 000 patient trial to our meta-analysis published in 2005.2 Our updated . . . [Full Text of this Article]


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