Document Detail

Rationale for the management of coronary syndromes with low-molecular-weight heparins.
MedLine Citation:
PMID:  9737475     Owner:  NLM     Status:  MEDLINE    
The well-documented disadvantages of unfractionated heparin in the management of coronary syndromes, such as unpredictable bioavailability and maintenance of therapeutic range, has prompted several studies into the benefits of low-molecular-weight heparins (LMWHs). The favorable pharmacologic properties of LMWHs include a binding affinity for antithrombin III, anti-factor IIa activity, excellent bioavailability, minimal protein binding, predictable anticoagulant response, and clinical tolerance by patients. LMWHs are also characterized by having a specific anti-factor Xa effect and inducing only a small prolongation in general clotting tests-i.e., activated partial thromboplastin time, prothrombin time, and antithrombin activity-when used in high doses. Several studies have recently demonstrated that LMWHs are superior to placebo and are at least equal or superior to standard heparin when added to aspirin for the treatment of unstable angina and following non-Q-wave myocardial infarction. These studies, which include Thrombolysis in Myocardial Infarction (TIMI) 11A and Efficacy and Safety of Subcutaneous Enoxaparin versus intravenous unfractionated heparin in Non-Q-wave Coronary Events (ESSENCE), will be reviewed and discussed.
E Gurfinkel; J Fareed; E Antman; M Cohen; B Mautner
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  82     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-28     Completed Date:  1998-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  15L-18L     Citation Subset:  AIM; IM    
Instituto de Cardiologia y Cirugia Cardiovascular, Fundacion Favaloro, Buenos Aires, Argentina.
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MeSH Terms
Aspirin / therapeutic use
Coronary Disease / drug therapy*
Drug Therapy, Combination
Fibrinolytic Agents / therapeutic use*
Heparin, Low-Molecular-Weight / therapeutic use*
Platelet Aggregation Inhibitors / therapeutic use
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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