Research suggests that the treatment with the low molecular weight heparin enoxaparin, in combination with the glycoprotein IIb/IIIa inhibitor eptifibatide, is both safe and effective for patients with acute coronary syndromes (ACS).

The findings come from the Integrilin and Enoxaparin Randomized Assessment of Acute Coronary Syndrome Treatment (INTERACT) trial, presented at the American College for Cardiology Conference 2002.

Shaun Goodman, from St Michael's Hospital, Toronto, Canada, led the 746-patient trial, which tracked major bleeding events after treatment with enoxaparin to unfractionated heparin (UFH), when both were used in combination with eptifibatide on ACS patients.

Forty-eight hours after administering therapy, the results showed major bleeding in 3.8% of UFH patients, but in only 1.1% of those on enoxaparin (p=0.014). This trend continued at 96 hours, when bleeding occurred in 4.6% of UF patients, and 1.8% of enoxaparin patients.

The incidence of ischemia was also higher in patients on UFH therapy, with 25% registering ischemic episodes compared with 14% of enoxaparin patients.

Furthermore, death rates after 30 days were lower in the enoxaparin group, compared with the UFH group (5% vs 9%, p=0.031), although combined death, re-myocardial infarction or current ischemia did not register as significantly different.

Only in terms of minor bleeding were enoxaparin patients at greater risk compared with those on UFH.

Commenting on his study, Goodman said: 'Enoxaparin improves outcome compared to currently recommended therapy of UF heparin in terms of safety and efficacy'.