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May 24/31, 2006

Low-Molecular-Weight Heparin vs Unfractionated Heparin in Acute Coronary Syndromes

Author Affiliations

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

JAMA. 2006;295(20):2353-2354. doi:10.1001/jama.295.20.2353-a

To the Editor: The SYNERGY trial compared enoxaparin and unfractionated heparin in high-risk patients with acute coronary syndromes. In their article describing the 6-month and 1-year outcomes, Dr Mahaffey and colleagues1 report a result that was not emphasized. As indicated in Figure 2B in their article, there was a statistically significant reduction in the hazard ratio for death or myocardial infarction in the group that consistently received enoxaparin. This benefit persisted for at least 6 months after initial treatment. However, there were no differences between the groups that received enoxaparin followed by unfractionated heparin, or the reverse.

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