What is the dosage regimen of low molecular weight heparin (LMWH) in the treatment of non-ST-elevation acute coronary syndrome (unstable angina and NSTEM), and what are the benefits and risks of enoxaparin?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Enoxaparin is given at a dose of 1 mg/kg subcutaneously (SC) every 12 hours. It should be continued for the duration of hospitalization or until PCI is performed. A dose reduction is required for patients with impaired kidney function.

Enoxaparin results in a more predictable and efficient anticoagulation compared to unfractionated heparin, leading to reduction in recurrent MI events [104, 105] ; however, there is possibly a higher bleeding risk in patients undergoing PCI. [106] These findings were demonstrated in the Efficacy and Safety of Subcutaneous Enoxaparin in Non–Q wave Coronary Events (ESSENCE) trial. [104, 105, 106]

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