Low-molecular-weight heparins in coronary thrombosis: today and tomorrow.
Data from several large-scale studies have suggested that low-molecular-weight heparin (LMWH) may be superior to standard heparin therapy in the setting of unstable coronary syndromes. Studies looking at the optimal duration of treatment have produced conflicting results; however, data from a recent large trial suggest that prolongation of treatment is associated with a significant benefit. The recommended initial treatment for patients with unstable coronary syndromes is a combination of LMWH and aspirin. Stablilized patients at moderate or high risk - such as those with ST-segment depression or increased troponin levels - should continue with this treatment until they have undergone coronary angiography and, if appropriate, an invasive procedure. In a recent small study among patients with acute myocardial infarction, the use of LMWH as an adjunct to streptokinase produced significant therapeutic benefits. Other potential uses for LMWH include a role in angioplasty.
Wallentin
L
L
Department of Cardiology, University Hospital, Uppsala, Sweden.
D000925:Anticoagulants / Q000627:therapeutic use*; D003328:Coronary Thrombosis / Q000188:drug therapy*; D004358:Drug Therapy / Q000639:trends; D005544:Forecasting; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight