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Editor's Correspondence
November 13, 2000

Dalteparin for Unstable Angina and Non–Q-Wave Myocardial Infarction

Arch Intern Med. 2000;160(20):3169-3170. doi:

I read with interest the review article by Weitz and Bates1 concerning new treatments for unstable angina and non–Q-wave myocardial infarction, which appeared in the March 27, 2000, issue of the ARCHIVES. I would like to comment about some aspects of the article.

With respect to low-molecular-weight heparins, only the Fragmin During Instability in Coronary Artery Disease (FRISC),2 Fragmin in Unstable Coronary Artery Disease (FRIC),3 Efficacy and Safety of Subcutaneous Enoxaparin in Non–Q-Wave Coronary Events (ESSENCE),4 and Thrombolysis in Myocardial Infarction (TIMI) 11B5 studies were considered in this review, and the authors conclude in the "Comment" section that 1 low-molecular-weight heparin (enoxaparin) has shown benefit in patients with unstable angina or non–Q-wave myocardial infarction. Results of the TIMI 11B5 trial were published in October 1999, but, previously, in August 1999, the results of the FRISC II study6 were published, and, surprisingly, they were not analyzed by Weitz and Bates. Moreover, Weitz and Bates' manuscript was accepted for publication June 29, 1999. The omission of analysis of the FRISC II study6 could result in incomplete information about the role of low-molecular-weight heparins in the treatment of the acute coronary syndromes.

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