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Enoxaparin versus Unfractionated Heparin in Elective Percutaneous Coronary Intervention

Despite its limitations, unfractionated heparin has been the standard anticoagulant used during percutaneous coronary intervention (PCI). Several small studies have suggested that intravenous enoxaparin may be a safe and effective alternative. Our primary aim was to assess the safety of enoxaparin as compared with that of unfractionated heparin in elective PCI. Methods In this prospective, open-label, multicenter, randomized trial, we randomly assigned 3528 patients with PCI to receive enoxaparin (0.5 or 0.75 mg per kilogram of body weight) or unfractionated heparin adjusted for activated clotting time, stratified according to the use or nonuse of glycoprotein IIb/IIIa inhibitors | Enoxaparin versus Unfractionated Heparin in Elective Percutaneous Coronary Intervention Enoxaparin versus Unfractionated Heparin in Elective Percutaneous Coronary Intervention Gilles Montalescot M.D. Ph.D. Harvey D. White M.B. Ch.B. D.Sc. Richard Gallo M.D. Marc Cohen M.D. P. Gabriel Steg M.D. Philip E.G. Aylward M.B. Ch.B. Ph.D. Christoph Bode M.D. Ph.D. Massimo Chiariello M.D. Spencer B. King III M.D. Robert A. Harrington M.D. Walter J. Desmet M.D. Carlos Macaya M.D. Ph.D. and Steven R. Steinhubl M.D. for the STEEPLE Investigators abstract From Institut de Cardiologie Centre Hospitalier Universitaire Pitié-Salpêtrière Paris G.M. the Green Lane Cardiovascular Service Auckland City Hospital Auckland New Zealand H.D.W. the Montreal Heart Institute Université de Montreal Montreal R.G. the Division of Cardiology Newark Beth Israel Medical Center Newark NJ M.C. the Service de Cardiologie Hôpital Bichat Paris P.G.S. Department of Cardiology Flinders Medical Center Adelaide SA Australia P.E.G.A. Abteilung Innere Medizin III Universi-tatsklinikum Freiburg Freiburg Germany C.B. the Division of Cardiology Federico 2nd University Naples Italy M.C. Fuqua Heart Center of Atlanta at Piedmont Hospital Atlanta S.B.K. the Division of Cardiology Duke University Medical Center Durham NC R.A.H. University Hospital Gasthuisberg Leuven Belgium W.J.D. Servicio de Cardiología Hospital Universitario Madrid C.M. and the Division of Cardiology University of Kentucky Lexington S.R.S. . Address reprint requests to Dr. Montalescot at Institut de Cardiologie Bureau 2-236 Centre Hospital-ier Universitaire Pitié-Salpêtrière 47 Boulevard de l Hôpital 75013 Paris France or at gilles.montalescot@psl.aphp.fr. Participants in the Safety and Efficacy of Enoxaparin in Percutaneous Coronary Intervention Patients an International Randomized Evaluation STEEPLE trial are listed in the Appendix. N Engl J Med 2006 355 1006-17. Copyright 2006 Massachusetts Medical Society. background Despite its limitations .