Percutaneous Coronary Intervention in Patients Receiving Enoxaparin or Unfractionated Heparin After Fibrinolytic Therapy for ST-Segment Elevation Myocardial Infarction in the ExTRACT-TIMI 25 Trial

Percutaneous Coronary Intervention in Patients Receiving Enoxaparin or Unfractionated Heparin After Fibrinolytic Therapy for ST-Segment Elevation Myocardial Infarction in the ExTRACT-TIMI 25 Trial C. Michael Gibson, Sabina A. Murphy, Gilles Montalescot, David A. Morrow, Diego Ardissino, Marc Cohen, Dietrich C. Gulba, Oscar H. Kracoff, Basil S. Lewis, Nathan Roguin, Elliott M. Antman, Eugene Braunwald, for the ExTRACT-TIMI 25 Investigators We sought to evaluate whether enoxaparin (ENOX) is superior to unfractionated heparin as adjunctive therapy for patients with ST-segment elevation myocardial infarction (STEMI) who receive fibrinolytic therapy and subsequently undergo percutaneous coronary intervention (PCI) by analyzing data from the EXTRACT–TIMI 25 (Enoxaparin and Thrombolysis Reperfusion for Acute MI Treatment) trial. Among patients treated with fibrinolytic therapy for STEMI who underwent subsequent PCI, ENOX administration was associated with a reduced risk of death or recurrent MI without difference in the risk of major bleeding. Administration of ENOX provided a seamless transition to the cardiac catheterization laboratory without the need for an additional antithrombin.