Sanofi-Aventis' low molecular weight heparin anticoagulant Clexane/Lovenox (enoxaparin) was boosted this week by ExTRACT, a 20,000-patient study presented by Professor Elliott Antman at the American College of Cardiology meeting in Atlanta and published online in the New England Journal of Medicine.

ExTRACT TIMI-25 shows the drug is superior to the current standard (unfractionated heparin) in protecting patients with severe (STEMI) heart attacks from dying or experiencing a further attack.

A one third reduction in further heart attacks and a 17.5% reduction in deaths, heart attacks and revascularisation was achieved at the expense of a modest increase in severe, but not fatal, bleeding.

Clexane/Lovenox is already the standard anticoagulant choice for less severe (NSTEMI) heart attacks and prevention of venous thromboembolism. Professor Keith Fox of Edinburgh University believes it will now become the standard for severe heart attacks also. “Enoxaparin is superior to UFH and is more convenient” he commented. UFH requires costly monitoring and lab tests.

“Guidelines will now look at enoxaparin in STEMI” he said. The drug would have further scope for studies in the treatment in patients with mini-strokes, he suggested.

From Olwen Glynn Owen at the ACC in Atlanta.