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October 27, 2004

Enoxaparin vs Unfractionated Heparin in Acute Coronary Syndrome—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(16):1952-1953. doi:10.1001/jama.292.16.1952-c

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.

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