title: [Decrease of total hemorrhage with reduced doses of enoxaparin in high risk unstable angina. ENHNFAI study. (Enoxaparin vs non-fractionated heparin in unstable angina). Preliminary report].
abstract: In this prospective, randomized and controlled study, we compare complications in 2 groups of patients: group 1, enoxaparin 0.8 mg/kg, subcutaneous every 12 hours during 5 days, and group 2, intravenous unfractionated heparin during 5 days, by infusion treated to activate partial tromboplastin time 1.5-2 the upper limit of normal. Blood samples were obtained at 4, 12, 24 hours and at day 5 of treatment, to measure anti-Xa levels, and also, evaluated end points at 30 days, between groups. Univariate and multivariate logistic regression analyses were performed with clinical and angiographic variables between groups, with p < 0.05.
  
  
  RESULTS
  203 consecutive patients, average age of 60.5 +/- 11.2 years, and 80% men, were included. There were no differences in clinical and angiographic characteristics. All patients with enoxaparin had therapeutic levels of anti-Xa, of 0.5 to 0.67 U/mL. There was increasing risk of total bleeding in group 2 (18.7%) than in group 1 (5.6%), with RR = 1.72 (95% CI 1.29, 2.29), p = .003. Also, there was 33.3% of MACE in group 2, and only 17.8% in group 1, with RR = 1.88 (CI 95% 1.29, 2.29), p = .011.
  
  
  CONCLUSIONS
  1) Low doses of enoxaparine achieve therapeutic levels, since the first 4 hours of treatment. 2) A significant reduction of total bleeding occurred with the low doses of enoxaparin, with the same efficacy to reduce MACE during follow-up.
authors.affiliation: Unidad Coronaria del Instituto Nacional de Cardiología lgnacio Chávez, INCICH, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, 14080 México, D.F.
authors.forename: José Victoria
authors.initials: JV
authors.lastname: Campos
authors.forename: Ursulo
authors.initials: U
authors.lastname: Juárez Herrera
authors.forename: Martín
authors.initials: M
authors.lastname: Rosas Peralta
authors.forename: Eulo
authors.initials: E
authors.lastname: Lupi Herrera
authors.forename: Héctor
authors.initials: H
authors.lastname: González Pacheco
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez Sánchez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Chuquiure Valenzuela
authors.forename: Gerardo
authors.initials: G
authors.lastname: Vieyra Herrera
authors.forename: Carlos
authors.initials: C
authors.lastname: Cardozo Zepeda
authors.forename: Carlos
authors.initials: C
authors.lastname: Barrera Sánchez
authors.forename: Jesús
authors.initials: J
authors.lastname: Reyes Corona
authors.forename: Evelyn
authors.initials: E
authors.lastname: Cortina de la Rosa
authors.forename: Aurora
authors.initials: A
authors.lastname: de la Peña Díaz
authors.forename: Raúl
authors.initials: R
authors.lastname: Izaguirre Avila
authors.forename: Andrés
authors.initials: A
authors.lastname: de la Peña Fernández
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000188:drug therapy*; D000925:Anticoagulants / Q000008:administration & dosage* / Q000097:blood; D017984:Enoxaparin / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D006493:Heparin / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D006493:Heparin