Antithrombotic therapy for acute coronary syndromes.

Objectives: To review the role of antithrombotic therapy for treatment of acute coronary syndromes (ACS) in the hospital setting.

Data Sources: Recent (1995-2003) published scientific literature, as identified by the authors through Medline searches, using the terms acute coronary syndromes, antithrombotic, antiplatelet, clinical trials, and reviews on treatment.

Study Selection: Recent systematic English-language review articles and reports of controlled randomized clinical trials were screened for inclusion.

Safety and efficacy of unfractionated heparin versus enoxaparin in patients who are obese and patients with severe renal impairment: analysis from the ESSENCE and TIMI 11B studies.

Background: The advantages of enoxaparin over unfractionated heparin (UFH) for the treatment of patients with non-ST-segment elevation acute coronary syndromes are well established. However, no data are available about the safety and efficacy in patients who are obese and patients with severe renal impairment.

Methods: A retrospective analysis of treatment effects was performed on patients who were obese and patients with severe renal impairment from the Efficacy Safety Subcutaenous Enoxaparin in Non-Q-wave Coronary Events (ESSENCE) and Thrombolysis in Myocardial Infarction (TIMI) 11B trials, in which patients were treated with enoxaparin or UFH.