Assessment of low-molecular-weight heparin trials in cardiology.
This review assesses the trial data for low-molecular-weight heparin (LMWH) use in cardiology. LMWHs have been shown to be more convenient to use compared with unfractionated heparin. The use of LMWHs in prevention and treatment of deep vein thrombosis is now established. Use of LMWHs in cardiology is gathering momentum. The most compelling published data are in unstable angina and non-Q-wave myocardial infarction (MI). LMWHs are at least as effective as unfractionated heparin in terms of the composite endpoint of death and MI. Conclusive benefits of LMWH use to prevent restenosis after stent insertion or percutaneous transluminal coronary angioplasty have not been established. The data in MI and atrial fibrillation are still preliminary, but encouraging.
Department of Pharmacy, University College London Hospitals, Mortimer Street, W1N 8AA, London, UK. robert.shulman@uclh.org
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D000789:Angina, Unstable / Q000188:drug therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy; D002986:Clinical Trials as Topic; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight