Low-molecular-weight heparins in the management of acute coronary syndromes.
Acute coronary syndromes (unstable angina and non-Q-wave myocardial infarction) are caused by the rupture of an atherosclerotic plaque, platelet activation, and fibrin deposition resulting in thrombosis. Aspirin and unfractionated heparin have traditionally been the treatments of choice for patients with acute coronary syndromes. Low-molecular-weight heparins offer potential advantages over unfractionated heparin, having proven equally effective for the treatment and prevention of many thromboembolic processes. Recently, a number of randomized controlled trials have been conducted to evaluate the role of low-molecular-weight heparins in the management of patients with unstable angina or non-Q-wave myocardial infarction. The purpose of this article is to review and evaluate the available literature on the use of low-molecular-weight heparins in the management of acute coronary syndromes to establish their role in therapy.
Zed
P J
PJ
CSU Pharmaceutical Sciences, Vancouver Hospital and Health Sciences Center, Faculty of Pharmaceutical Sciences, University of British Columbia, Canada. zed@interchange.ubc.ca
Tisdale
J E
JE
Borzak
S
S
D000789:Angina, Unstable / Q000188:drug therapy; D002170:Canada; D003327:Coronary Disease / Q000188:drug therapy*; D017985:Dalteparin / Q000627:therapeutic use; D017984:Enoxaparin / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D017762:Nadroparin / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000078222:Tinzaparin; D014481:United States
D017984:Enoxaparin; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D017762:Nadroparin; D000078222:Tinzaparin; D017985:Dalteparin; C093450:ardeparin