Brigham and Women's Cardiac Group Finds Enoxaparin Strategy is Better Than Commonly Administered Blood Thinning Strategy for Heart Attacks

Brigham and Women's Cardiac Group Finds Enoxaparin Strategy is Better Than Commonly Administered Blood Thinning Strategy for Heart Attacks

March 15, 2006

New Therapy Significantly Reduces Risk of Repeat Heart Attack and Death

    BOSTON, March 15 /Xinhua-PRNewswire/ -- Doctors
treating patients who have suffered an acute heart attack
can now employ a better, more effective blood thinning
strategy, using a medication called enoxaparin, to prevent
blood clots from reforming in heart arteries.  The use of
enoxaparin in this strategy significantly reduced the risk
of repeat heart attack or death, compared to the most
commonly administered anticoagulant regimen in use today,
according to findings from the Brigham and Women's
ExTRACT-TIMI 25 trial.  The findings will be presented at
the 2006 American College of Cardiology's Annual Scientific
Session in Atlanta GA., Tuesday, March 14, and in an early
release paper to be published in the New England Journal of
Medicine.

    The ExTRACT-TIMI 25 (Enoxaparin and Thrombosis
Reperfusion for Acute Myocardial Infarction Treatment --
Thrombolysis in Myocardial Infarction) trial was a
randomized, double-blind, double-dummy comparison of two
anticoagulant strategies in more than 20,000 patients in 48
countries whose primary treatment for heart attack was
injection of a clot busting medication (fibrinolytic
therapy).  A new strategy using enoxaparin, a low molecular
weight heparin, was used for the duration of the heart
attack patient's hospitalization and was compared with the
current strategy of the commonly prescribed blood thinner,
unfractionated heparin for at least 48 hours.  The TIMI
Study Group determined which of the two blood thinning
strategies was more effective at preventing heart attack
patients from either dying or having a second but nonfatal
heart attack within one month after treatment.

    The results showed that the risk of death or recurrent
non-fatal heart attack was significantly reduced by 17 per
cent for patients who were administered the enoxaparin
strategy compared to those who received the unfractionated
heparin strategy.  The benefits of the enoxaparin strategy
became apparent within 48 hours.  At the end of one month,
the risk of recurrent non-fatal heart attack was
significantly reduced by 33 per cent for patients given the
enoxaparin strategy compared with those given the
unfractionated heparin strategy.  A total of 7.5 per cent
of patients who received unfractionated heparin died
compared to 6.9 per cent who were given enoxaparin.

    Elliott Antman, M.D. Director, Samuel A. Levine Cardiac
Unit at Brigham and Women's Hospital, Professor of Medicine,
Harvard Medical School, and lead author of the ExTRACT-TIMI
25 study said, "The results of this trial are dramatic
and significant; a strategy using enoxaparin prevents more
patients from dying or having a second heart attack within
30 days of treatment compared to the strategy using
unfractionated heparin, which up to now has been considered
the standard blood thinner regimen used to support
fibrinolytic therapy."  He continued,
"Enoxaparin, a modified form of unfractionated
heparin, interrupts the clotting system more efficiently
and more reliably than unfractionated heparin.  By doing
so, enoxaparin prevents blood clots from forming again in
arteries that carry blood to the heart muscle."

    The rates of serious bleeding overall were lower than
reported in previous trials.  The patients who received the
enoxaparin strategy compared with the unfractionated heparin
strategy did have a small but significant increase in the
risk of serious bleeding episodes.  However, when the
balance of benefits and risks where weighed ("net
clinical benefit") the results strongly favored the
enoxaparin strategy.

    The study has critical importance for the treatment of
most patients who suffer a heart attack.  Dr. Antman said.
"Although opening a blocked coronary artery with a
balloon-tipped catheter, or percutaneous coronary
intervention, has been shown to be an effective treatment
for heart attack patients who come to specialized centers,
the vast majority of patients worldwide receive
clot-busting medications to treat their heart
attack."

    "Based on the results of the ExTRACT-TIMI 25
trial, we believe that the enoxaparin strategy is now the
preferred anticoagulant regimen to use in heart attack
patients who receive clot-busting drugs," said Eugene
Braunwald, M.D., M.A.C.C., Chairman, TIMI Study Group,
Brigham and Women's Hospital and Distinguished Hersey
Professor of Medicine, Harvard Medical School.

    The research was supported by a grant from
Sanofi-Aventis.

    Brigham and Women's Hospital is a 747-bed nonprofit
teaching affiliate of Harvard Medical School and a founding
member of Partners HealthCare System, an integrated health
care delivery network. BWH is committed to excellence in
patient care with expertise in virtually every specialty of
medicine and surgery. The BWH medical preeminence dates back
to 1832 and today that rich history in clinical care is
coupled with its national leadership in quality improvement
and patient safety initiatives, dedication to educating and
training health care professionals, and strength in
biomedical research. With $370M in funding and more than
500 research scientists, BWH is an acclaimed leader in
clinical, basic and epidemiological investigation --
including the landmark Nurses Health Study, Physicians
Health Studies, and the Women's Health Initiative. For more
information about BWH, please visit:
www.brighamandwomens.org

    For more information, please contact:
     
     Kevin C. Myron
     Brigham and Women's Hospital
     Tel:   [phone]
     Email: [e-mail]

SOURCE  Sanofi-aventis