The role of low-molecular-weight heparin in the management of acute coronary syndromes

Authors
Citation
M. Cohen, The role of low-molecular-weight heparin in the management of acute coronary syndromes, CURR OPIN C, 16(6), 2001, pp. 384-389
Citations number
46
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
CURRENT OPINION IN CARDIOLOGY
ISSN journal
0268-4705 → ACNP
Volume
16
Issue
6
Year of publication
2001
Pages
384 - 389
Database
ISI
SICI code
0268-4705(200111)16:6<384:TROLHI>2.0.ZU;2-F
Abstract
Optimized medical treatment for the non-ST segment elevation acute coronary syndromes (NSTE ACS) should consist of a combined antithrombotic/anti-angi nal regimen. Standard antithrombotic treatment is currently unfractionated heparin and aspirin, and in high-risk patients glycoprotein IIb/IIIa inhibi tors, However, low-molecular-weight heparins (LMWHs) have practical and cli nical advantages over UFH and can be considered an effective alternative in the medical treatment of ACS and in patients proceeding to surgical interv entions. Benefits include a more predictable and stable therapeutic respons e, no need for coagulation monitoring and a reduced incidence heparin-induc ed thrombocytopenia. In this context, the LMWH enoxaparin has demonstrated sustained clinical and economic benefits compared with UFH, with no increas e in major bleeding complications. In addition, recently published studies indicate that LMWHs can improve reperfusion of the arteries and reduce reoc clusion when used as adjunctive anticoagulant therapy in patients with ST s egment elevation (STE) ACS undergoing thrombolysis with fibrin-specific age nts or streptokinase. (C) 2001 Lippincott Williams & Wilkins, Inc.