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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.292.16.1953-a

In Reply: In response to Dr Pedrini and colleagues, we did not design our study to evaluate the important question of the duration of antithrombin therapy. Our protocol suggested a minimum duration of treatment with unfractionated or low-molecular-weight heparin of 48 hours, but treatment duration could be shortened for those undergoing early percutaneous intervention, with heparin discontinuation permitted 12 hours after intervention. Maximal duration for study-provided medications was limited to 120 hours by protocol. Although not based on data from randomized controlled trials, this strategy is consistent with American College of Cardiology/American Heart Association guideline recommendations.1

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