Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: We are concerned that the recent
studies on enoxaparin vs unfractionated heparin leave the duration of heparin
treatment ill-defined for patients with acute coronary syndromes.
In the SYNERGY trial,1 duration of drug
administration was left to the judgment of the treating physician. SYNERGY
was an open-label trial, and subcutaneous enoxaparin is more convenient than
intravenous unfractionated heparin, which could lead to longer treatment.
Therefore, it is possible that differences between enoxaparin and unfractionated
heparin may be biased by longer treatment with 1 study drug. SYNERGY did not
present actual duration of treatment.
Pedrini M, Hartig F, Pechlaner C. Enoxaparin vs Unfractionated Heparin in Acute Coronary Syndrome. JAMA. 2004;292(16):1952-1953. doi:10.1001/jama.292.16.1952-a