6/28/23, 10:01 PM ESSENCE Pathway Feedback Search Clinical Topics Home Studies ESSENCE ESSENCE Disease Non-ST-elevation myocardial inf Trial question Is enoxaparin superior to UFH in patients with angina at rest or non-Q-wave myocardial infarction receiving aspirin? Study design Multi-center Double blinded RCT Population Characteristics of study participants 33.0% female N = 3171 67.0% male 3171 patients (1059 female, 2112 male) Inclusion criteria: patients with angina at rest or non-Q-wave myocardial infarctio receiving aspirin Key exclusion criteria: left bundle-branch block or pacemaker, persistent ST-segment elevation, angina with HF or tachydysrhythmia, contraindications to anticoagulation, or a CrCl rate < 30 ml/min Interventions N=1607 enoxaparin (1 mg/kg of body weight SC BID for a minimum of 48 hours to maximum of 8 days) N=1564 UFH (continuous intravenous UFH for a minimum of 48 hours to maximum of 8 days) Primary outcome Death, myocardial infarction, or recurrent angina at 14 days https://web.pathway.md/studies/rec7UvmPii7texVYq 1/2 6/28/23, 10:01 PM ESSENCE Pathway 19.8 % 19.8 16.6 14.9 % 9.9 % Significant decrease 5.0 % NNT = 31 0.0 % Enoxaparin Unfractionated heparin Significant decrease in death, myocardial infarction, or recurrent angina at 14 days (16.6% vs. 19.8%; OR 0.8, 95% CI 0.67 to 0.96) Secondary outcomes Significant increase in need for revascularization at 30 days (27.1% vs. 32.2%; RR 16, 95% CI 6.51 to 25.49) Safety outcomes No significant difference in major bleeding at 30 days (6.5% vs. 7.0%). Significant differences in overall bleeding (18.4% vs. 14.2%, p = 0.001). Conclusion In patients with angina at rest or non-Q-wave myocardial infarctio receiving aspirin, enoxaparin was superior to UFH with respect to death, myocardial infarction, or recurrent angina at 14 days. Reference Cohen M, Demers C, Gurfinkel EP et al. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group. N Engl J Med. 1997 Aug 14;337(7):447-52. Open reference URL https://web.pathway.md/studies/rec7UvmPii7texVYq 2/2