Related Experiment Video
Updated: Dec 17, 2025
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Comparative Effectiveness and Costs of Enoxaparin Monotherapy Versus Unfractionated Heparin Monotherapy in Treating
Ning Rosenthal1, Zhimin Xiao2, Alex Kartashov3
1Premier Applied Sciences, Premier Healthcare Solutions Inc., 13034 Ballantyne Corporate Place, Charlotte, NC, 28277, USA. ning_rosenthal@premierinc.com.
Insights
Enoxaparin showed lower ischemic complications, death risk, and major bleeding than unfractionated heparin (UFH) in NSTEMI patients. This real-world data suggests enoxaparin offers better outcomes and cost savings for acute coronary syndrome treatment.
Area of Science:
- Cardiology
- Pharmacoeconomics
- Real-world evidence
Background:
- Enoxaparin and unfractionated heparin (UFH) are standard anticoagulants for acute coronary syndrome (ACS).
- Existing evidence primarily comes from clinical trials, with limited real-world economic data.
- This study compares enoxaparin and UFH in ACS treatment using real-world data.
Purpose of the Study:
- To examine real-world differences in utilization, effectiveness, safety, and costs between enoxaparin and UFH monotherapy in ACS patients.
- To evaluate the economic impact of anticoagulant choice in ACS management.
- To inform optimal anticoagulant selection for improved clinical outcomes and cost-effectiveness.
Main Methods:
- Analysis of real-world data from 859 US hospitals (2010-2016).
- Inclusion of adult inpatients with an initial ACS diagnosis (UA, NSTEMI, STEMI).
- Comparison of 30-day outcomes (ischemic events, bleeding, mortality) and costs using multivariable regression.
Main Results:
- Enoxaparin use varied by ACS type (5.1%-13.9%).
- Enoxaparin demonstrated lower ischemic complications and mortality in NSTEMI, and reduced major bleeding across all ACS types.
- Significant cost savings observed with enoxaparin: $2475 (NSTEMI) to $3050 (STEMI) per patient.
Conclusions:
- Enoxaparin offers superior safety, effectiveness, and cost-efficiency compared to UFH in NSTEMI patients.
- Real-world data supports enoxaparin use for improved outcomes and reduced healthcare costs in specific ACS populations.
- Optimizing upstream anticoagulant selection can enhance clinical results and economic value.
Background:
Enoxaparin and unfractionated heparin (UFH) are guideline-recommended anticoagulants for patients with acute coronary syndrome (ACS), including unstable angina (UA) and myocardial infarction with (STEMI) or without ST-segment elevation (NSTEMI). Prior efficacy and safety evidence are mainly from clinical trials. Economic data are insufficient. This study examined the differences in utilization, effectiveness, safety, and costs in treating ACS between enoxaparin and UFH monotherapy using real-world data.
Methods:
Using data from 859 US hospitals, inpatients ≥ 18 years of age with a diagnosis of an initial episode of ACS between 2010 and 2016 were identified. Outcomes included 30-day risk of non-fatal myocardial infarction (MI), recurrent angina, in-hospital mortality, composite ischemic complication (having MI/recurrent angina/death), major bleeding, and costs. Multivariable regression was used to compare outcomes between enoxaparin and UFH monotherapy.
Results:
Among 1,048,053 eligible patients (UA: 219,259; NSTEMI: 582,134; STEMI: 246,660), the prevalence of enoxaparin monotherapy was 12.0%, 13.9%, and 5.1%, and the prevalence of UFH monotherapy was 45.1%, 43.1% and 59.8%, for UA, NSTEMI, and STEMI patients, respectively. Enoxaparin was associated with a lower risk of ischemic complications and death among NSTEMI, but not in UA or STEMI patients, and with a lower risk of major bleeding in all patients. Cost savings per patient during index admission and 30-day follow-up for enoxaparin over UFH was $2972 for UA, $2475 for NSTEMI, and $3050 for STEMI.
Conclusions:
Enoxaparin was associated with a lower risk of ischemic complications (including death), lower costs, and better safety than UFH among NSTEMI patients. Improving upstream selection of anticoagulants in appropriate populations may help optimize clinical outcomes and costs.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
09:21Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:29Venous Thrombosis III: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction
01:26Acute Coronary Syndrome V: Nursing Management