{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:39:39Z","timestamp":1774312779581,"version":"3.50.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2005,12,20]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Low-molecular-weight heparin (LMWH) offers pharmacological and practical advantages over unfractionated heparin (UFH). Whether these advantages translate into greater infarct-related artery patency and fewer adverse clinical events in patients with ST-elevation myocardial infarction (STEMI) receiving fibrinolytic therapy remains under study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    We compared angiographic and clinical outcomes in patients treated with LMWH (n=1429) versus UFH (n=1431) in CLARITY-TIMI 28, a randomized trial of clopidogrel versus placebo in STEMI patients aged 18 to 75 years undergoing fibrinolysis. After comprehensive adjustment for baseline characteristics, therapeutic interventions, and a propensity score, treatment with LMWH was associated with a significantly lower rate of a closed infarct-related artery or death or myocardial infarction before angiography (13.5% versus 22.5%, adjusted OR 0.76,\n                    <jats:italic>P<\/jats:italic>\n                    =0.027). Treatment with LMWH was also associated with a significantly lower rate of cardiovascular death or recurrent myocardial infarction through 30 days (6.9% versus 11.5%, adjusted OR 0.68,\n                    <jats:italic>P<\/jats:italic>\n                    =0.030). The lower event rates were observed in patients allocated to clopidogrel and in those who underwent percutaneous coronary intervention. Rates of TIMI major bleeding through 30 days (1.6% versus 2.2%,\n                    <jats:italic>P<\/jats:italic>\n                    =0.27) and intracranial hemorrhage (0.6% versus 0.8%,\n                    <jats:italic>P<\/jats:italic>\n                    =0.37) were similar in the LMWH and UFH groups. Patients who received both clopidogrel and LMWH, in addition to a standard fibrinolytic and aspirin, had a particularly high rate of infarct-related artery patency (90.9%) and particularly low rates of cardiovascular death (3.2%), recurrent myocardial infarction (3.0%), and major bleeding (1.8%).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    In patients with STEMI receiving fibrinolytic therapy, use of LMWH with other standard therapies, including clopidogrel and aspirin, is associated with improved angiographic outcomes and lower rates of major adverse cardiovascular events.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.105.595397","type":"journal-article","created":{"date-parts":[[2005,11,15]],"date-time":"2005-11-15T22:08:16Z","timestamp":1132092496000},"page":"3846-3854","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Angiographic and Clinical Outcomes in Patients Receiving Low-Molecular-Weight Heparin Versus Unfractionated Heparin in ST-Elevation Myocardial Infarction Treated With Fibrinolytics in the CLARITY-TIMI 28 Trial"],"prefix":"10.1161","volume":"112","author":[{"given":"Marc S.","family":"Sabatine","sequence":"first","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Morrow","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Montalescot","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Dellborg","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose L.","family":"Leiva-Pons","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matyas","family":"Keltai","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina A.","family":"Murphy","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn H.","family":"McCabe","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Michael","family":"Gibson","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliott M.","family":"Antman","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Braunwald","sequence":"additional","affiliation":[{"name":"From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Mass (M.S.S., D.A.M., S.A.M., C.H.M., C.M.G., C.P.C., E.M.A., E.B.); Institut de Cardiologie, Ho\u0302pital Pitie\u0301-Salpe\u0302trie\u0300re, Paris, France (G.M.); Department of Medicine, Sahlgrenska University Hospital, Goteborg, Sweden (M.D.); Interventional Cardiology, Department Hospital Central San Luis Potosi, Mexico (J.L.L.-P.);..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.103.18.2310"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.1.55"},{"key":"e_1_3_2_3_2","first-page":"45","volume":"292","year":"2004","unstructured":"Ferguson JJ, Califf RM, Antman EM, Cohen M, Grines CL, Goodman S, Kereiakes DJ, Langer A, Mahaffey KW, Nessel CC, Armstrong PW, Avezum A, Aylward P, Becker RC, Biasucci L, Borzak S, Col J, Frey MJ, Fry E, Gulba DC, Guneri S, Gurfinkel E, Harrington R, Hochman JS, Kleiman NS, Leon MB, Lopez-Sendon JL, Pepine CJ, Ruzyllo W, Steinhubl SR, Teirstein PS, Toro-Figueroa L, White H. Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial. JAMA. 2004; 292: 45\u201354.","journal-title":"JAMA"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.3.331"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050522"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67660-X"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17059-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.11.006"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.110.9.e82"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-4-256"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112339"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a010011"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.104.6.648"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00006-X"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000013402.34759.46"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1187"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.3_suppl.188S"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.98.4.294"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi104"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505183322003"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V79.1.1.1"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(02)00131-X"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05775-0"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000081659.72985.a8"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.82.3.2394002"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00492-0"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.08.038"},{"key":"e_1_3_2_28_2","unstructured":"Montalescot G. Safety and Efficacy of Enoxaparin in Percutaneous Coronary Intervention Patients (STEEPLE). Presented at: European Society of Cardiology Congress 2005; 2005; Stockholm Sweden."},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.10.1224"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.105.595397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:12:32Z","timestamp":1715562752000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.105.595397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,12,20]]},"references-count":29,"journal-issue":{"issue":"25","published-print":{"date-parts":[[2005,12,20]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.105.595397"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.105.595397","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1109.458596","asserted-by":"object"}]},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,12,20]]},"assertion":[{"value":"2005-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}