Clinical trials have reported the beneficial effects of
platelet glycoprotein (
GP) IIb/IIIa receptor antagonists and low-molecular-weight heparins (
LMWH) on major
cardiac events (
MACE) in patients presenting with
unstable angina or
non-ST elevation myocardial infarction. A number of studies have documented the significant superiority of low-molecular-weight heparins, especially
enoxaparin, over
unfractionated heparin in the treatment of
acute coronary syndromes. The purpose of this study was to compare the effects of two different LMWHs,
enoxaparin and
nadroparin, accompanied by platelet
GP IIb/IIIa inhibition on
MACE in high-risk
unstable angina. The study was designed as an open-label and observational study. Sixty-eight patients presenting with
unstable angina associated with high-risk criteria were randomly assigned to treatment with
enoxaparin plus
tirofiban (36 patients, mean age 57 +/- 11) or
nadroparin plus
tirofiban (32 patients, mean age: 58 +/- 8). In-hospital
MACE including acute
myocardial infarction (AMI), recurrent refractory angina, death,
stroke, and urgent revascularization were compared between the study groups. Patient characteristics and durations of
LMWH and
tirofiban treatments were not different between the study groups. Coronary artery risk factors, except family history (which was observed more frequently in the
enoxaparin group, P = 0.02), were also similar.
MACE between the
enoxaparin and
nadroparin groups including AMI (5.5%, 6%), recurrent refractory angina (19%, 12%), death (0%, 3%),
stroke (was not observed in either group), urgent revascularization (14%, 12%) and total
MACE (19%, 15%) were not different.
Enoxaparin and
nadroparin, accompanied by
GP IIb/IIIa inhibitor
therapy, have similar effects on the development of major
cardiac events in patients presenting with
unstable angina and high-risk characteristics.