Comparative Study of Heparin and Enoxaparin in Reducing Mortality and Reinfarction in STEMI Patients: A Retrospective Observational Analysis

Abstract

ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular emergency requiring rapid reperfusion and anticoagulation. While Unfractionated Heparin (UFH) has long been a standard treatment, Low Molecular Weight Heparins (LMWHs) such as Enoxaparin have demonstrated superior pharmacological and clinical profiles. This study aims to compare the real-world effectiveness of Heparin versus Enoxaparin in reducing mortality and reinfarction in STEMI patients in a tertiary care hospital in India. A retrospective observational study was conducted at Shivapuje Heart Care Hospital, Latur, involving 100 STEMI patients admitted between September 2024 and February 2025. Patients were grouped based on anticoagulant therapy: Heparin (n=50) and Enoxaparin (n=50). Data on in-hospital and follow-up mortality, reinfarction, complications, and recovery were analyzed using Fisher’s exact test and Odds Ratios (OR), with a significance threshold of p < 0.05. The Enoxaparin group demonstrated significantly lower in-hospital mortality (4% vs 16%) and reinfarction rates (6% vs 24%) compared to the Heparin group. Follow-up mortality (6% vs 28%) and reinfarction (8% vs 28%) were also substantially reduced with Enoxaparin. Fewer bleeding complications and better overall clinical recovery (90% vs 80%) were observed in the Enoxaparin group. ORs strongly favored Enoxaparin for both mortality (OR = 0.14) and reinfarction (OR = 0.15), with high statistical significance (p < 0.001). Enoxaparin is more effective and safer than Heparin in managing STEMI, offering significant reductions in mortality, reinfarction, and complications. These findings support the broader adoption of Enoxaparin as the preferred anticoagulant in both urban and resource-limited clinical settings.