Document Detail

The thrombin hypothesis in ACS: a disappointing disconnect between bench data and bedside clinical trials.
MedLine Citation:
PMID:  20103015     Owner:  NLM     Status:  MEDLINE    
Studies have demonstrated the efficacy and safety of unfractionated heparin and low-molecular-weight heparin in the management of patients with acute coronary syndrome. However, a common limitation of unfractionated heparin and low-molecular-weight heparin is that neither can neutralize clot-bound thrombin. To overcome this limitation of the broad heparin-based anticoagulants, novel anticoagulants targeted for both the free and clot-bound forms of thrombin (direct thrombin inhibitors), or other individual components of the coagulation cascade (eg, direct and indirect factor Xa inhibitors), were developed. These targeted anticoagulation agents showed promising results in preclinical testing and have been evaluated in large-scale clinical acute coronary syndrome trials. This review discusses the disconnect between the excellent preclinical findings obtained with these novel, targeted agents and the efficacy and safety data observed in patients with acute coronary syndrome, compared with the broader-range heparin-based anticoagulants.
Marc Cohen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  123     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-10     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Division of Cardiology, Newark Beth Israel Medical Center, Newark, NJ; Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA.
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MeSH Terms
Acute Coronary Syndrome / drug therapy*
Anticoagulants / therapeutic use*
Factor Xa / antagonists & inhibitors
Heparin / therapeutic use*
Platelet Aggregation Inhibitors / therapeutic use
Protease Inhibitors / therapeutic use
Thrombin / antagonists & inhibitors*
Treatment Outcome
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 0/Protease Inhibitors; 9005-49-6/Heparin; EC; EC Xa

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

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