Use of anticoagulants in ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention: a potential role for enoxaparin.

Unfractionated heparin (UFH) is currently given as the standard anticoagulant therapy in ST-elevation myocardial infarction (STEMI) patients, including those undergoing percutaneous coronary intervention (PCI). Recent data, however, have shown lower rates of death or recurrent myocardial infarction (MI) with the low-molecular-weight heparin (LMWH) enoxaparin compared with UFH in STEMI patients treated with thrombolytics, off-setting an increase in major bleeding. This review compares the use of enoxaparin with UFH in STEMI patients undergoing PCI, within the context of available evidence for other anticoagulant drugs. Evidence is accumulating for the preferential use of enoxaparin in STEMI patients undergoing PCI.