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Canadian Health and Care Mall: Acute Coronary Syndromes

Acute coronary syndromesWe read with interest the article from Macie et al (May 2004) highlighting the importance of adhering to the correct dosing of enoxaparin for the prevention of ischemic events in patients with unstable angina or non-ST-segment elevation myocardial infarction. The article adds to the current controversy over dosing practices for enoxaparin in obese patients, while discussing the risk factors for increased bleeding. We would like to add the following points:

The optimal dose of enoxaparin for treatment of acute coronary syndromes (ACS) is 1 mg/kg, and this dose should be adhered to—ie, no more and no less. There is evidence that when the dose is adjusted down unnecessarily, survival and efficacy is reduced, thus emphasizing the importance of a correct dosing regimen.

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