Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: We agree with Dr Pedrini and colleagues
that the appropriate duration of anticoagulation therapy in patients with
non–ST-segment elevation acute coronary syndromes has not been rigorously
evaluated. While trials could be designed to investigate optimal duration,
the study requirements are potentially prohibitive. A trial with random allocation
of patients to 1 of 2 study drugs for various intervals of therapy such as
1 hour, 4 hours, and 12 hours would require an enormous sample size to detect
differences in outcomes.
Mahaffey KW, Ferguson JJ, Califf RM, SYNERGY Trial Investigators FT. Enoxaparin vs Unfractionated Heparin in Acute Coronary Syndrome—Reply. JAMA. 2004;292(16):1952-1953. doi:10.1001/jama.292.16.1952-c