Defining optimal therapy for the thrombolysis-ineligible patient

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Updated: Aug 19, 2026

Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Marc Cohen1

  • 1Division of Cardiology, Hahnemann University Hospital, Philadelphia, Pennsylvania 19102, USA. marc.cohen@tenethealth.com

Clinical Cardiology
|November 14, 2002
PubMed

Insights

Enoxaparin and tirofiban show excellent efficacy and safety for patients with ST-elevation myocardial infarction (STEMI) ineligible for reperfusion therapy. This combination offers a vital treatment option for acute coronary syndrome (ACS) patients who cannot undergo standard reperfusion procedures.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Not all acute coronary syndrome (ACS) patients can receive reperfusion therapy due to late presentation or bleeding risks.
  • Effective alternative treatments are crucial for patients with acute ST-elevation myocardial infarction (STEMI) who are ineligible for reperfusion.
  • Low-molecular-weight heparin, specifically enoxaparin, has demonstrated superiority over unfractionated heparin in thrombolytic therapy adjuncts.

Purpose of the Study:

  • To evaluate the efficacy and safety of enoxaparin in combination with tirofiban.
  • To assess this combination therapy in STEMI patients ineligible for reperfusion therapy.

Main Methods:

  • A clinical trial was conducted to assess enoxaparin plus tirofiban in STEMI patients.
  • Blinded data from the entire patient cohort was analyzed.

Main Results:

  • The combination therapy demonstrated excellent efficacy in the studied patient cohort.
  • The treatment regimen also showed an excellent safety profile.

Conclusions:

  • Enoxaparin combined with tirofiban presents a promising therapeutic option for STEMI patients unsuitable for reperfusion.
  • This approach addresses a critical unmet need in managing specific acute coronary syndrome populations.

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